Healthcare Provider Details

I. General information

NPI: 1801365820
Provider Name (Legal Business Name): JANICE MARIEL CUEVAS RIVERA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2018
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8540 S SEPULVEDA BLVD STE 1100
LOS ANGELES CA
90045-3819
US

IV. Provider business mailing address

2800 PLAZA DEL AMO UNIT 305
TORRANCE CA
90503-9321
US

V. Phone/Fax

Practice location:
  • Phone: 310-568-8938
  • Fax:
Mailing address:
  • Phone: 787-432-8329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number21156
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number205293
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: