Individual
JANNELLE RIVAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4164 BROCKTON AVE, RIVERSIDE, CA 92501-3400
(951) 683-5193
Mailing address
4164 BROCKTON AVE, RIVERSIDE, CA 92501-3400
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
Primary
MPSS-EBDJFR
CA
225400000X
Rehabilitation Practitioner
—
—
Other
Enumeration date
10/06/2023
Last updated
09/23/2025
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