Provider Demographics
NPI:1114265063
Name:RIVERA, BRIANNA (MA)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:RIVERA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1270 KALANIIKI ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96821-1213
Mailing Address - Country:US
Mailing Address - Phone:808-640-6252
Mailing Address - Fax:
Practice Address - Street 1:1100 ALAKEA ST STE 900
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2851
Practice Address - Country:US
Practice Address - Phone:808-523-7771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-28
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIHOO598102101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor