Individual
MRS. LYNETTE J. RIVINIUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, MS, CNS, CDE
Contact information
Practice address
22552 LARK ST, GRAND TERRACE, CA 92313-5716
(909) 380-4397
Mailing address
22552 LARK ST, GRAND TERRACE, CA 92313-5716
(909) 380-4397
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
260455
CA
364S00000X
Clinical Nurse Specialist
Primary
1318
CA
Other
Enumeration date
01/06/2009
Last updated
01/06/2009
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