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General NPI Number Information
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NPI Number | 1225851629
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Entity Type | Individual
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Provider Name | RICHARD RIVERA PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 11/04/2024
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Last Update Date | 02/09/2025
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Provider Practice Location Address
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Address Line | 89 CLIFFSIDE CT
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City | SANFORD
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State | NC
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Zip | 27332-9500
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Country | US
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Telephone | 910-633-2533
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Fax |
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Provider Business Mailing Address
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Address Line | 89 CLIFFSIDE CT
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City | SANFORD
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State | NC
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Zip | 27332-9500
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Country | US
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Telephone | 910-633-2533
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 406639
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | L8-0010760
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License Number State | DE
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 5021379
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License Number State | NC
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