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1093210197 NPI number — TAMLA NOEL RIVERS

NPI Number: 1093210197
Health Care Provider/Practitioner: TAMLA NOEL RIVERS

Information about “1093210197” NPI (TAMLA NOEL RIVERS) exists in 1093210197 in HTML format HTML  |  1093210197 in plain Text format TXT  |  1093210197 in PDF (Portable Document Format) PDF  |  1093210197 in an XML format XML  formats.

NPI Number : 1093210197 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1093210197",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "RIVERS",
    "FirstName": "TAMLA",
    "MiddleName": "NOEL",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "3461 S CHESTER AVE APT 20",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BAKERSFIELD",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "93304-6171",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "661-427-3965",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1002 19TH ST STE 202",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BAKERSFIELD",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "93301-4728",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "661-427-3965",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "03/29/2018",
    "LastUpdateDate": "11/05/2023",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "1744P3200X",
        "TaxonomyName": "Prosthetics Case Management",
        "LicenseNumber": "A8161824",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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