Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Edward Halomoan Siahaan, CTRS

Individual provider Recreation Therapist · NPI 1205771086

Edward Halomoan Siahaan, CTRS is a Recreation Therapist in Riverside, California. Licensed in California. Registered with an NPI since 2026.

Licensed in
CA
In the registry since
2026

Practice location Address checks out

3933 Harrison St
Riverside, CA 92503-3523
Phone: (833) 391-0505
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Recreation Therapist (primary) Taxonomy 225800000X · Licence CTRS32156 (CA)

Record details

NPI number1205771086
Entity typeIndividual (Type 1)
GenderMale
Credentials CTRS
Sole proprietorNo
NPI enumeratedApril 20, 2026
Last updated in NPPESApril 20, 2026
Certification dateApril 20, 2026

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