Healthcare Provider Details

I. General information

NPI: 1902726714
Provider Name (Legal Business Name): MELISSA RIVERA, A MARRIAGE AND FAMILY THERAPY CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N LOS ROBLES AVE APT 35
PASADENA CA
91101-1319
US

IV. Provider business mailing address

PO BOX 90691
PASADENA CA
91109-0691
US

V. Phone/Fax

Practice location:
  • Phone: 626-421-2360
  • Fax:
Mailing address:
  • Phone: 626-421-2360
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. MELISSA RAQUEL RIVERA
Title or Position: PRESIDENT
Credential: LMFT
Phone: 626-421-2360