Individual
JONATHAN RIVAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, ATC
Contact information
Practice address
6301 DE SOTO AVE UNIT 104, WOODLAND HILLS, CA 91367-2739
(818) 629-7401
Mailing address
6301 DE SOTO AVE UNIT 104, WOODLAND HILLS, CA 91367-2739
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
CA
Other
Enumeration date
10/17/2023
Last updated
07/07/2024
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