MEDICARE: MRS. JANETTE ZENAIDA RIVERA MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	5568	PR

General Provider Information

NPI Number	:	1013136639
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JANETTE ZENAIDA RIVERA MSW

Provider Business Mailing Address
First Line	:	127 CALLE WESER
Second Line	:	RIO PIEDRA HEIGHTS
City	:	SAN JUAN
State	:	PR
Zip	:	00926-3103
Country	:	US
Telephone Number	:	787-210-9088
Fax Number	:	787-767-4068

Provider Business Practice Location Address
First Line	:	127 CALLE WESER
Second Line	:	RIO PIEDRA HEIGHTS
City	:	SAN JUAN
State	:	PR
Zip	:	00926-3103
Country	:	US
Telephone Number	:	787-210-9088
Fax Number	:	787-767-4068

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/24/2007
Last Update Date	:	07/08/2007

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