Provider Demographics
NPI:1922213008
Name:RIVERA, DIANA (MHC)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:RIVERA
Suffix:
Gender:F
Credentials:MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:193 SUPERIOR DR
Mailing Address - Street 2:A
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-1669
Mailing Address - Country:US
Mailing Address - Phone:408-347-3120
Mailing Address - Fax:408-347-3121
Practice Address - Street 1:101 JOSE FIGUERES AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-2022
Practice Address - Country:US
Practice Address - Phone:408-347-3120
Practice Address - Fax:408-347-3121
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor