Healthcare Provider Details

I. General information

NPI: 1154090306
Provider Name (Legal Business Name): GRISELDA RIVERA PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2021
Last Update Date: 09/10/2021
Certification Date: 09/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 STINE RD
BAKERSFIELD CA
93309-4827
US

IV. Provider business mailing address

429 BELMONT ST
DELANO CA
93215-3225
US

V. Phone/Fax

Practice location:
  • Phone: 866-707-6664
  • Fax:
Mailing address:
  • Phone: 661-372-9154
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number84847
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: