Provider Demographics
NPI:1750154290
Name:RIVERA, ROSA MARIA
Entity type:Individual
Prefix:
First Name:ROSA
Middle Name:MARIA
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:PO BOX 332
Mailing Address - Street 2:
Mailing Address - City:LOS MOLINOS
Mailing Address - State:CA
Mailing Address - Zip Code:96055-0332
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7875 HIGHWAY 99E
Practice Address - Street 2:
Practice Address - City:LOS MOLINOS
Practice Address - State:CA
Practice Address - Zip Code:96055-9782
Practice Address - Country:US
Practice Address - Phone:530-315-3700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347E00000XTransportation ServicesTransportation Broker