Provider Demographics
NPI:1861961278
Name:RIVERA, MONICA VIVIANA
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:VIVIANA
Last Name:RIVERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 CHICO ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93305-5937
Mailing Address - Country:US
Mailing Address - Phone:661-619-0312
Mailing Address - Fax:
Practice Address - Street 1:8787 HALL RD
Practice Address - Street 2:
Practice Address - City:LAMONT
Practice Address - State:CA
Practice Address - Zip Code:93241-1953
Practice Address - Country:US
Practice Address - Phone:661-845-3717
Practice Address - Fax:661-845-3385
Is Sole Proprietor?:No
Enumeration Date:2018-11-14
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator