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General NPI Number Information
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NPI Number | 1326915802
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Entity Type | Individual
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Provider Name | CANDACE TRUSHAY RIVERA
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Gender | Female
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Dates
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Enumeration Date | 10/20/2025
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Last Update Date | 10/20/2025
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Provider Practice Location Address
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Address Line | 3132 JEFFERSON ST
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City | SAN DIEGO
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State | CA
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Zip | 92110-4421
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Country | US
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Telephone | 619-682-3100
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Fax | 610-682-4037
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Provider Business Mailing Address
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Address Line | 340 HART DR APT 14
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City | EL CAJON
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State | CA
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Zip | 92021-4550
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Country | US
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Telephone | 619-571-1169
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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 | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State | CA
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