Provider Demographics
NPI:1063663375
Name:RIBEIRO, LIVIA LORENA (BACHELORS DEGREE)
Entity Type:Individual
Prefix:MS
First Name:LIVIA
Middle Name:LORENA
Last Name:RIBEIRO
Suffix:
Gender:F
Credentials:BACHELORS DEGREE
Other - Prefix:MRS
Other - First Name:LIVIA
Other - Middle Name:LORENA
Other - Last Name:WATERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1910 CALIFORNIA STREET
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-2870
Mailing Address - Country:US
Mailing Address - Phone:707-443-9747
Mailing Address - Fax:707-443-7277
Practice Address - Street 1:1910 CALIFORNIA ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-2870
Practice Address - Country:US
Practice Address - Phone:707-443-9747
Practice Address - Fax:707-443-7277
Is Sole Proprietor?:No
Enumeration Date:2008-10-06
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator