MEDICARE: JAIDA 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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1578413126
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAIDA RIVERA

Provider Business Mailing Address
First Line	:	11066 PETAL AVE
Second Line	:
City	:	FOUNTAIN VALLEY
State	:	CA
Zip	:	92708-1728
Country	:	US
Telephone Number	:	714-650-3600
Fax Number	:

Provider Business Practice Location Address
First Line	:	1901 CARNEGIE AVE
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92705-5504
Country	:	US
Telephone Number	:	800-273-4292
Fax Number	:

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

Provider Enumeration Date	:	02/02/2026
Last Update Date	:	02/02/2026

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Directions to “ JAIDA RIVERA ” Practice Location

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