Healthcare Provider Details

I. General information

NPI: 1609797919
Provider Name (Legal Business Name): ELIZET RIVAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1352 WESTSIDE ST
PORTERVILLE CA
93257-1141
US

IV. Provider business mailing address

1352 WESTSIDE ST
PORTERVILLE CA
93257-1141
US

V. Phone/Fax

Practice location:
  • Phone: 559-586-4464
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberNA
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: