Provider Demographics
NPI:1740164094
Name:CASA RIVERA WELLNESS, LICENSED CLINICAL SOCIAL WORKER, PC
Entity type:Organization
Organization Name:CASA RIVERA WELLNESS, LICENSED CLINICAL SOCIAL WORKER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:LUZ
Authorized Official - Middle Name:
Authorized Official - Last Name:CORDOVA ZEPEDA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:805-680-1272
Mailing Address - Street 1:1200 PUNTA GORDA ST SPC 37
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93103-3584
Mailing Address - Country:US
Mailing Address - Phone:805-680-1272
Mailing Address - Fax:
Practice Address - Street 1:1200 PUNTA GORDA ST SPC 37
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93103-3584
Practice Address - Country:US
Practice Address - Phone:805-680-1272
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-31
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty