MEDICARE: SYDNEY 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
1	103K00000X	Behavior Analyst	1999	TN
2	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1518627959
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYDNEY RIVERA

Provider Business Mailing Address
First Line	:	1849 LAKEWOOD VILLAGE DR
Second Line	:
City	:	ANTIOCH
State	:	TN
Zip	:	37013-1530
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5209 LINBAR DR STE 625
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37211-1025
Country	:	US
Telephone Number	:	615-570-9959
Fax Number	:

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

Provider Enumeration Date	:	12/27/2021
Last Update Date	:	11/24/2025

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Directions to “ SYDNEY RIVERA ” Practice Location

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