Individual
IRAIDA RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3333 CHANATE RD, SANTA ROSA, CA 95404-1707
(707) 565-4935
Mailing address
1523 ALHAMBRA AVE, MARTINEZ, CA 94553-2403
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
796084
CA
363L00000X
Nurse Practitioner
Primary
95008058
CA
Other
Enumeration date
04/25/2012
Last updated
12/18/2017
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