Rene Rivera

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA66154 Issued in CA

Practice address

2650 S Bristol St Ste 101
Santa Ana, CA 92704-5751

Phone

(714) 754-1444

NPI assigned

Sep 19, 2024

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: rene.rivera.p4@direct.scpeds.nextgenshare.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1726704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746230400000",
    "number": "1023845252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 W PINE ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927033942",
            "telephone_number": "714-519-5234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 S BRISTOL ST STE 101",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927045751",
            "telephone_number": "714-754-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "RENE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-19",
        "last_updated": "2025-05-03",
        "certification_date": "2025-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA66154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• July Rivera, LVN
• Leslie Jaquelyn Rivera, MS, RD
• Luis Eduardo Rivera, M.D.
• Natalie Estela Rivera
• Nathan Rivera
• Sandra Rivera
• Tiffany Lynn Rivera
• Pilar Rivero Chan
• Christian Ivan Rivero, ACSW
• Jose Rizo Jr., SUDCC

• Physician Assistant in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.