Provider Demographics
NPI:1851476733
Name:RIVERA, REBECCA SUSAN
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:SUSAN
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 1:1445 VISTA WAY
Mailing Address - Street 2:
Mailing Address - City:RED BLUFF
Mailing Address - State:CA
Mailing Address - Zip Code:96080-4510
Mailing Address - Country:US
Mailing Address - Phone:530-527-5631
Mailing Address - Fax:
Practice Address - Street 1:1445 VISTA WAY
Practice Address - Street 2:
Practice Address - City:RED BLUFF
Practice Address - State:CA
Practice Address - Zip Code:96080-4510
Practice Address - Country:US
Practice Address - Phone:530-527-5631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health