Healthcare Provider Details

I. General information

NPI: 1053759639
Provider Name (Legal Business Name): DR. ALICIA RIVERA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2013
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date: 11/10/2025
Reactivation Date: 11/26/2025

III. Provider practice location address

444 E HUNTINGTON DR
ARCADIA CA
91006-6203
US

IV. Provider business mailing address

PO BOX 6881
ALHAMBRA CA
91802-6881
US

V. Phone/Fax

Practice location:
  • Phone: 626-639-8844
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number135320
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: