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Individual
IRENE LISA RIVAS
Active
Individual
IRENE LISA RIVAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
RI-R1209070829
CA
171M00000X
Case Manager/Care Coordinator
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RI-R1209070829
CAADE
CA
Enumeration date
08/29/2014
Last updated
11/30/2020
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