Provider Demographics
NPI:1730714841
Name:RIVERA, NADYA FAITH
Entity type:Individual
Prefix:
First Name:NADYA
Middle Name:FAITH
Last Name:RIVERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NADYA
Other - Middle Name:FAITH
Other - Last Name:GUTIERREZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3355 MISSION AVE STE 237
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92058-1322
Mailing Address - Country:US
Mailing Address - Phone:760-688-9150
Mailing Address - Fax:
Practice Address - Street 1:3355 MISSION AVE STE 237
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92058-1322
Practice Address - Country:US
Practice Address - Phone:760-688-9150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-09
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)