Healthcare Provider Details

I. General information

NPI: 1831094028
Provider Name (Legal Business Name): LUCIA ALESSANDRA RIVERA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/11/2026
Certification Date: 10/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 N 24TH ST
PHOENIX AZ
85008-6056
US

IV. Provider business mailing address

958 E CARLA VISTA PL
CHANDLER AZ
85225-8800
US

V. Phone/Fax

Practice location:
  • Phone: 602-244-1331
  • Fax: 602-542-0883
Mailing address:
  • Phone: 602-244-1331
  • Fax: 602-542-0883

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number292904
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: