Healthcare Provider Details

I. General information

NPI: 1649631623
Provider Name (Legal Business Name): MRS. KAREN RIVERA APOLINAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KAREN RIVERA

II. Dates (important events)

Enumeration Date: 03/17/2016
Last Update Date: 12/29/2023
Certification Date: 12/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 E. IMPERIAL HWY
FULLERTON CA
92835-1145
US

IV. Provider business mailing address

2035 E BALL RD
ANAHEIM CA
92806-5159
US

V. Phone/Fax

Practice location:
  • Phone: 714-447-7000
  • Fax: 714-447-7003
Mailing address:
  • Phone: 714-517-6140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number118284
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: