Healthcare Provider Details

I. General information

NPI: 1851342307
Provider Name (Legal Business Name): PATRICIA RIVERA O.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

919 N MAIN ST
SALINAS CA
93906-3912
US

IV. Provider business mailing address

PO BOX 612260
SAN JOSE CA
95161-2260
US

V. Phone/Fax

Practice location:
  • Phone: 831-754-0833
  • Fax: 831-754-4358
Mailing address:
  • Phone: 877-325-2776
  • Fax: 408-945-4011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT 8197
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: