Provider Demographics
NPI:1346819984
Name:RIVEROS ACOSTA, ANDREA CATALINA (L AC)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:CATALINA
Last Name:RIVEROS ACOSTA
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2410 LINCOLN AVE APT E
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-2915
Mailing Address - Country:US
Mailing Address - Phone:925-322-9079
Mailing Address - Fax:
Practice Address - Street 1:2410 LINCOLN AVE APT E
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-2915
Practice Address - Country:US
Practice Address - Phone:925-322-9079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-18
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist