Individual provider Active NPI

Eliza Rivera-Mitu, PMHNP-BC, FNP-C

  • Primary Care Nurse Practitioner
  • Fountain Valley, CA
National Provider Identifier
1104167758
Registry record updated Jun 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
23310 Issued in CA
Practice address
11100 Warner Ave Ste 162
Fountain Valley, CA 92708-7510
Phone
(562) 786-6723
Fax
(562) 786-6956
NPI assigned
Mar 6, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2026

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 23310 CA Primary
Registered Nurse 163W00000X 507599 CA
Family Nurse Practitioner 363LF0000X 23310 CA
Adult Health Nurse Practitioner 363LA2200X 23310 CA
Health Educator 174H00000X 507599 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 23310 CA

Addresses

Primary practice location

11100 Warner Ave Ste 162
Fountain Valley, CA 92708-7510

Mailing address

21515 Hawthorne Blvd Ste 200
Torrance, CA 90503-6512
Phone (562) 786-6723

Other practice location 1

21515 Hawthorne Blvd Ste 200
Torrance, CA 90503-6512
Phone (562) 786-6723

Other identifiers 2

IdentifierTypeStateIssuer
251KFFVQMedicaidCA
23310OtherCABOARD OF REGISTERED NURSING LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200417000822 CA Practitioner - Nurse Practitioner 0840422424 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

21515 Hawthorne Blvd
Suite 200
Torrance, CA 90503-6512
Phone (562) 786-6723

2390 Crenshaw Blvd
Suite E254
Torrance, CA 90501-3300

Hospital & facility affiliations

  • Quality Home Health Care, Inc Home health agency, Covina, CA, CCN 557478
  • Sunnyland Home Health Care, Inc Home health agency, Glendale, CA, CCN 559210

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Eliza Rivera Mitu Aprn FNP C a Professional Nursing Corporation Psychiatric/Mental Health CurrentSince Oct 6, 2024 Accepting new patients
Baart Community Healthcare CurrentSince Mar 12, 2021 Accepting new patients
Baart Community Healthcare Current Accepting new patients
Baart Community Healthcare CurrentSince Mar 12, 2021 Accepting new patients

Locations

11100 Warner Ave
Ste 162
Fountain Vly, CA 92708
Phone (714) 432-1212

1926 Beverly Blvd
Los Angeles, CA 90057
Phone (213) 353-1140

1701 Zonal Ave
Los Angeles, CA 90033
Phone (323) 223-6146

21515 Hawthorne Blvd
Ste 200
Torrance, CA 90503
Phone (310) 371-7984

2390 Crenshaw Blvd
Ste E254
Torrance, CA 90501
Phone (562) 661-8974

1720 Lakepointe Dr
Ste 117
Lewisville, TX 75057

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1362528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781827200000",
    "number": "1104167758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21515 HAWTHORNE BLVD STE 200",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905036512",
            "telephone_number": "562-786-6723",
            "fax_number": "562-786-6956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 WARNER AVE STE 162",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087510",
            "telephone_number": "562-786-6723",
            "fax_number": "562-786-6956"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21515 Hawthorne Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "905036512",
            "country_code": "US",
            "telephone_number": "562-786-6723",
            "fax_number": "562-786-6956",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVERA-MITU",
        "first_name": "ELIZA",
        "credential": "PMHNP-BC, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-06",
        "last_updated": "2026-06-19",
        "certification_date": "2026-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "23310",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "507599",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "23310",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "23310",
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": "CA",
            "license": "507599",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "23310",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "251KFFVQ",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF REGISTERED NURSING LICENSE NUMBER",
            "identifier": "23310",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

Verify at the official NPI Registry.