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General NPI Number Information
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NPI Number | 1164731154
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Entity Type | Individual
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Provider Name | ROXANA RIVERA
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Gender | Female
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Dates
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Enumeration Date | 09/24/2010
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Last Update Date | 09/24/2010
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Provider Practice Location Address
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Address Line | 714 N AVALON BLVD
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City | WILMINGTON
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State | CA
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Zip | 90744-5809
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Country | US
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Telephone | 310-816-9700
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Fax | 310-816-9750
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Provider Business Mailing Address
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Address Line | 2550 W MAIN ST STE 301
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City | ALHAMBRA
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State | CA
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Zip | 91801-7003
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Country | US
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Telephone | 626-457-6900
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Fax | 626-457-1233
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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