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General NPI Number Information
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NPI Number | 1205228699
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Entity Type | Individual
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Provider Name | LOVELLE RIVERA
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Gender | Female
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Dates
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Enumeration Date | 02/23/2015
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Last Update Date | 11/02/2024
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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 | 12318 WILLOW HILL DR
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City | MOORPARK
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State | CA
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Zip | 93021-2765
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Country | US
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Telephone | 661-523-9414
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Fax |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 593704
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 22020
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 593704
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License Number State | CA
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