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General NPI Number Information
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NPI Number | 1740750843
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Entity Type | Individual
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Provider Name | NOE RIVERA M.S., LMFT
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Gender | Male
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Dates
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Enumeration Date | 11/30/2018
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Last Update Date | 12/08/2023
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Provider Practice Location Address
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Address Line | 100 W FOOTHILL BLVD STE 104
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City | SAN DIMAS
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State | CA
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Zip | 91773-1170
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Country | US
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Telephone | 626-602-5548
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2121
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City | IRWINDALE
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State | CA
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Zip | 91706-1085
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Country | US
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Telephone | 626-600-1161
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 124949
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License Number State | CA
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