Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1316340474 |
---|---|
Provider Name | Christine Sophia Rivera |
First Address | Los Angeles, CA 90027 |
Second Address | Monrovia, CA 91016-3427 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2014 |
Last Update Date | 08/09/2017 |