Provider Demographics
NPI:1356637789
Name:RIVERA, ARLENE BAGAIN (MS, LPCC)
Entity Type:Individual
Prefix:
First Name:ARLENE
Middle Name:BAGAIN
Last Name:RIVERA
Suffix:
Gender:F
Credentials:MS, LPCC
Other - Prefix:
Other - First Name:ARLENE
Other - Middle Name:
Other - Last Name:BAGAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LPCC
Mailing Address - Street 1:617 VETERANS BLVD STE 212
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-1419
Mailing Address - Country:US
Mailing Address - Phone:650-898-2420
Mailing Address - Fax:
Practice Address - Street 1:617 VETERANS BLVD
Practice Address - Street 2:SUITE 212
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-1496
Practice Address - Country:US
Practice Address - Phone:650-898-2420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-23
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12101YP2500X
CA2587101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional