IndividualActive
Edward Siahaan, CTRS
NPI 1205771086 · Recreation Therapist · Riverside, CA
Provider details
- NPI number
- 1205771086
- Entity type
- Individual
- Primary specialty
- Recreation TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- CTRS
- Sex
- Male
- Sole proprietor
- No
- License
- CTRS32156 (CA)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
3933 Harrison St
Riverside, CA 92503-3523
Phone: (833) 391-0505
Approximate (ZIP-level) locationGet directions
Mailing address
3933 Harrison St
Riverside, CA 92503-3523
Registry dates
- Enumerated
- 2026-04-20
- Last updated
- 2026-04-20
- Certified
- 2026-04-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.