Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1144887928 |
---|---|
Provider Name | Mr. Nathan J Riera |
First Address | Santa Cruz, CA 95060-1976 |
Second Address | Santa Cruz, CA 95060-1976 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2019 |
Last Update Date | 28/05/2019 |