Healthcare Provider Details

I. General information

NPI: 1134591175
Provider Name (Legal Business Name): BETTY ALICIA RIVERA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/29/2015
Last Update Date: 05/21/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 E COMPTON BLVD
COMPTON CA
90221-3303
US

IV. Provider business mailing address

550 S VERMONT AVE
LOS ANGELES CA
90020-1912
US

V. Phone/Fax

Practice location:
  • Phone: 310-668-6800
  • Fax:
Mailing address:
  • Phone: 800-550-7771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW59722
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberASW59722
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: