Individual
LISA LOUISE RIVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
520 SUPERIOR AVE STE 255, NEWPORT BEACH, CA 92663-3668
(949) 360-0300
Mailing address
265 FLOWER ST, COSTA MESA, CA 92627-2837
(949) 633-0500
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP95007823
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000
—
CA
05
—
XXXXXXX
—
CA
Enumeration date
05/08/2018
Last updated
06/16/2018
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