Provider Demographics
NPI:1609153816
Name:RIVERA, CHELSEA N (LPTNMHPP)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:N
Last Name:RIVERA
Suffix:
Gender:F
Credentials:LPTNMHPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:841 N ARBOR DR
Mailing Address - Street 2:
Mailing Address - City:TULARE
Mailing Address - State:CA
Mailing Address - Zip Code:93274-2306
Mailing Address - Country:US
Mailing Address - Phone:559-469-9927
Mailing Address - Fax:
Practice Address - Street 1:841 N ARBOR DR
Practice Address - Street 2:
Practice Address - City:TULARE
Practice Address - State:CA
Practice Address - Zip Code:93274-1660
Practice Address - Country:US
Practice Address - Phone:559-469-9927
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-16
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 33105167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician