Individual
MR. RAYMOND RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC 11
Contact information
Practice address
995 GATEWAY CENTER WAY, SAN DIEGO, CA 92102-4500
(619) 772-2579
Mailing address
1031 25TH ST, SAN DIEGO, CA 92102-2102
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
—
—
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
04/04/2011
Last updated
04/23/2025
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