Active NPI
Nancy E Rivera, LMFT
- Mental Health Counselor
- Yorba Linda, CA
National Provider Identifier
1013581016
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 115549
- Practice address
- 22600 Savi Ranch Pkwy # a-38
Yorba Linda, CA 92887-4606 - Phone
- (657) 204-6381
- NPI assigned
- May 14, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 115549 | CA | Primary |
Addresses
Primary practice location
22600 Savi Ranch Pkwy # a-38
Yorba Linda, CA 92887-4606
Mailing address
2121 W. Imperial Hwy.
Sute E #160
La Habra, CA 90631
Phone (657) 204-6381
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 84-3492093 | Other | CA | IRS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 115549 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620950400000",
"number": "1013581016",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2121 W. IMPERIAL HWY.",
"address_2": "SUTE E #160",
"city": "LA HABRA",
"state": "CA",
"postal_code": "90631",
"telephone_number": "657-204-6381"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22600 SAVI RANCH PKWY # A-38",
"city": "YORBA LINDA",
"state": "CA",
"postal_code": "928874606",
"telephone_number": "657-204-6381"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA",
"first_name": "NANCY",
"middle_name": "E",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-05-14",
"last_updated": "2021-05-14",
"certification_date": "2021-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "115549",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IRS",
"identifier": "84-3492093",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Yorba Linda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.