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NPI Code Detail

MEDICARE: LISETTE CAROLINA RIVAS-HERMINA M.S.

MEDICARE: LISETTE CAROLINA RIVAS-HERMINA M.S.
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
1106H00000XMarriage & Family TherapistMFCC42272CA

General Provider Information

NPI Number : 1487784393
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISETTE CAROLINA RIVAS-HERMINA M.S.
Provider Business Mailing Address
First Line : 711 S NEW HAMPSHIRE AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90005-1831
Country : US
Telephone Number : 213-385-5100
Fax Number :
Provider Business Practice Location Address
First Line : 711 S NEW HAMPSHIRE AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90005-1831
Country : US
Telephone Number : 213-385-5100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/07/2007
Last Update Date : 07/08/2007

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Directions to “ LISETTE CAROLINA RIVAS-HERMINA M.S.” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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