Provider Demographics
NPI:1881410009
Name:RIVERA, ALAN RAMON
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:RAMON
Last Name:RIVERA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4775 W 18TH LN
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-6646
Mailing Address - Country:US
Mailing Address - Phone:928-446-5236
Mailing Address - Fax:
Practice Address - Street 1:7201 E 31ST PL
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85365-8394
Practice Address - Country:US
Practice Address - Phone:928-336-5660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-03
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical