Provider Demographics
NPI:1700231701
Name:RIVAS, JOSE (OTR/L)
Entity Type:Individual
Prefix:MR
First Name:JOSE
Middle Name:
Last Name:RIVAS
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8600 W. 3RD. STREET
Mailing Address - Street 2:SUITE 3B HOLLYWOOD HANDS REHABILITATION
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048
Mailing Address - Country:US
Mailing Address - Phone:310-275-2130
Mailing Address - Fax:310-275-2131
Practice Address - Street 1:8600 W. 3RD. STREET
Practice Address - Street 2:SUITE 3B HOLLYWOOD HANDS REHABILITATION
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048
Practice Address - Country:US
Practice Address - Phone:310-275-2130
Practice Address - Fax:310-275-2131
Is Sole Proprietor?:No
Enumeration Date:2016-04-27
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT16130225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist