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NPI Code Detail

MEDICARE: DAVID GABRIEL RIVERA

MEDICARE: DAVID GABRIEL RIVERA
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
1101YM0800XMental Health CounselorNACA
2390200000XStudent in an Organized Health Care Education/Training Program
3106H00000XMarriage & Family TherapistAMFT132838

General Provider Information

NPI Number : 1174079925
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID GABRIEL RIVERA
Provider Business Mailing Address
First Line : 1902 MARENGO ST STE 107
Second Line :
City : LOS ANGELES
State : CA
Zip : 90033-1378
Country : US
Telephone Number : 213-447-3680
Fax Number :
Provider Business Practice Location Address
First Line : 238 S FLOWER ST
Second Line :
City : ORANGE
State : CA
Zip : 92868-3415
Country : US
Telephone Number : 714-978-6682
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2016
Last Update Date : 06/08/2023

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Directions to “ DAVID GABRIEL RIVERA ” Practice Location

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