Provider Demographics
NPI:1023210820
Name:RIVAS, NATALIA (CADDE)
Entity Type:Individual
Prefix:MS
First Name:NATALIA
Middle Name:
Last Name:RIVAS
Suffix:
Gender:F
Credentials:CADDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 MADISON AVENUE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92116-3691
Mailing Address - Country:US
Mailing Address - Phone:619-429-4117
Mailing Address - Fax:
Practice Address - Street 1:1515 PALM AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92154-1011
Practice Address - Country:US
Practice Address - Phone:629-429-4117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)