Healthcare Provider Details

I. General information

NPI: 1245408376
Provider Name (Legal Business Name): SHERALEE DENISE RIVERA CPHW/CCE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2008
Last Update Date: 02/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4010 E CHAPMAN AVE STE C
ORANGE CA
92869-3990
US

IV. Provider business mailing address

4010 E CHAPMAN AVE STE C
ORANGE CA
92869-3990
US

V. Phone/Fax

Practice location:
  • Phone: 714-532-6222
  • Fax: 714-532-3943
Mailing address:
  • Phone: 714-532-6222
  • Fax: 714-532-3943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: