Individual
LESDY I RIVERA JOVEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
340 CA-HWY 138, CRESTLINE, CA 92325
(909) 336-3330
Mailing address
340 CA HWY 138, CRESTLINE, CA 92325
(909) 336-3330
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
172V00000X
Community Health Worker
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
01/07/2021
Last updated
05/22/2025
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