Provider Demographics
NPI:1356143812
Name:RIVAS, EMILI DOLORES
Entity type:Individual
Prefix:
First Name:EMILI
Middle Name:DOLORES
Last Name:RIVAS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5385 HOLLISTER AVE BLDG 11
Mailing Address - Street 2:
Mailing Address - City:GOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:93111-2389
Mailing Address - Country:US
Mailing Address - Phone:805-725-0649
Mailing Address - Fax:
Practice Address - Street 1:5385 HOLLISTER AVE BLDG 11
Practice Address - Street 2:
Practice Address - City:GOLETA
Practice Address - State:CA
Practice Address - Zip Code:93111-2389
Practice Address - Country:US
Practice Address - Phone:805-725-0649
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician