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NPI Code Detail

MEDICARE: VALERIE RIVAS

MEDICARE: VALERIE RIVAS
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1841070851
Entity Type Code : Individual
Provider Name (Legal Business Name) : VALERIE RIVAS
Provider Business Mailing Address
First Line : 8548 SIERRA MADRE AVE
Second Line :
City : RANCHO CUCAMONGA
State : CA
Zip : 91730-4234
Country : US
Telephone Number : 909-286-8816
Fax Number :
Provider Business Practice Location Address
First Line : 9229 UTICA AVE
Second Line :
City : RANCHO CUCAMONGA
State : CA
Zip : 91730-5435
Country : US
Telephone Number : 909-689-4135
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2023
Last Update Date : 10/05/2023

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Directions to “ VALERIE RIVAS ” Practice Location

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