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General NPI Number Information
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NPI Number | 1164392338
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Entity Type | Organization
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Legal Business Name | CANYON PRIMARY CARE
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Dates
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Enumeration Date | 11/11/2025
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 26910 SIERRA HWY STE D8
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City | SANTA CLARITA
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State | CA
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Zip | 91321-2262
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Country | US
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Telephone | 661-388-5750
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Fax |
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Provider Business Mailing Address
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Address Line | 26910 SIERRA HWY STE D8
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City | SANTA CLARITA
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State | CA
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Zip | 91321-2262
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Country | US
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Telephone | 661-388-5750
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | LOVELLE RIVERA
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Credential | NP
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Telephone | 661-523-9414
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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