Individual
FERNANDO LUIS RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
232 E GISH RD, SAN JOSE, CA 95112-4706
(408) 876-4284
Mailing address
232 E GISH RD, SAN JOSE, CA 95112-4706
(669) 302-9745
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
175T00000X
Peer Specialist
MPSS-FWMJPU
CA
225400000X
Rehabilitation Practitioner
Primary
MPSS-FWMJPU
CA
Other
Enumeration date
07/12/2022
Last updated
06/16/2025
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