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NPI Code Detail

MEDICARE: ALFONSO RIVERA JR. AMFT

MEDICARE: ALFONSO RIVERA JR. AMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist162174CA

General Provider Information

NPI Number : 1891633541
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALFONSO RIVERA JR. AMFT
Provider Business Mailing Address
First Line : 700 FREDERICK ST STE 103
Second Line :
City : SANTA CRUZ
State : CA
Zip : 95062-2239
Country : US
Telephone Number : 831-996-1222
Fax Number : 831-417-0443
Provider Business Practice Location Address
First Line : 700 FREDERICK ST STE 103
Second Line :
City : SANTA CRUZ
State : CA
Zip : 95062-2239
Country : US
Telephone Number : 831-996-1222
Fax Number : 831-417-0443
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2026
Last Update Date : 03/24/2026

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