Individual
DOLORES JAZMIN RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
47915 OASIS ST, INDIO, CA 92201-6950
(760) 863-8600
Mailing address
88-455 AVE. 57TH SPACE 4, THERMAL, CA 92274
(442) 200-8922
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
225C00000X
Rehabilitation Counselor
—
—
273R00000X
Psychiatric Hospital Unit
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
93773825D
—
CA
Enumeration date
01/09/2020
Last updated
01/09/2020
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