Healthcare Provider Details

I. General information

NPI: 1073169728
Provider Name (Legal Business Name): JEFFREY RILVERIA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2019
Last Update Date: 09/11/2025
Certification Date: 07/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4411 E CESAR CHAVEZ BLVD # 319
FRESNO CA
93702-3604
US

IV. Provider business mailing address

400 W MINERAL KING AVE
VISALIA CA
93291-6237
US

V. Phone/Fax

Practice location:
  • Phone: 559-600-2382
  • Fax: 559-475-7866
Mailing address:
  • Phone: 559-206-2420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number1073169728
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: