Provider Demographics
NPI:1740568864
Name:RIVERA, MARCELA
Entity Type:Individual
Prefix:MS
First Name:MARCELA
Middle Name:
Last Name:RIVERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9033 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:PICO RIVERA
Mailing Address - State:CA
Mailing Address - Zip Code:90660-3839
Mailing Address - Country:US
Mailing Address - Phone:562-942-9625
Mailing Address - Fax:
Practice Address - Street 1:9033 WASHINGTON BLVD.
Practice Address - Street 2:
Practice Address - City:PICO RIVERA
Practice Address - State:CA
Practice Address - Zip Code:90660
Practice Address - Country:US
Practice Address - Phone:562-942-9625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-22
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator