Active NPI
Dolores Jazmin Rivera
- Peer Specialist
- Indio, CA
National Provider Identifier
1104466929
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- Practice address
- 47915 Oasis St
Indio, CA 92201-6950 - Phone
- (760) 863-8600
- NPI assigned
- Jan 9, 2020
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Counselor | 225C00000X | |||
| Psychiatric Hospital Unit | 273R00000X | |||
| Peer Specialist | 175T00000X | Primary |
Addresses
Primary practice location
47915 Oasis St
Indio, CA 92201-6950
Mailing address
88-455 Ave. 57TH Space 4
Thermal, CA 92274
Phone (442) 200-8922
Other practice location 1
47915 Oasis St
Indio, CA 92201-6950
Phone (760) 863-8650
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 93773825D | Medicaid | CA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Drivera@telecarecorp.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1578528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578528000000",
"number": "1104466929",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "88-455 AVE. 57TH SPACE 4",
"city": "THERMAL",
"state": "CA",
"postal_code": "92274",
"telephone_number": "442-200-8922"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "47915 OASIS ST",
"city": "INDIO",
"state": "CA",
"postal_code": "922016950",
"telephone_number": "760-863-8600"
}
],
"practiceLocations": [
{
"address_1": "47915 Oasis St",
"address_purpose": "LOCATION",
"city": "Indio",
"state": "CA",
"postal_code": "922016950",
"country_code": "US",
"telephone_number": "760-863-8650",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RIVERA",
"first_name": "DOLORES",
"middle_name": "JAZMIN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-01-09",
"last_updated": "2020-01-09",
"certification_date": "2020-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "225C00000X",
"taxonomy_group": "",
"desc": "Rehabilitation Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "273R00000X",
"taxonomy_group": "",
"desc": "Psychiatric Unit",
"state": null,
"license": null,
"primary": false
},
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "93773825D",
"state": "CA"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Drivera@telecarecorp.com",
"affiliation": "N",
"endpointDescription": "Mental Health",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "47915 Oasis St",
"city": "Indio",
"state": "CA",
"country_code": "US",
"postal_code": "922016950",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Indio, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.