Individual provider Active NPI

Carol A Rivero, PH.D.

  • Clinical Psychologist
  • Sacramento, CA
National Provider Identifier
1104856202
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY8891 Issued in CA
Practice address
3560 J Street, #6
Sacramento, CA 95816
Phone
(916) 447-0490
NPI assigned
Jul 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY8891 CA
Clinical Psychologist 103TC0700X PSY8891 CA Primary

Addresses

Primary practice location

3560 J Street, #6
Sacramento, CA 95816

Mailing address

2443 Fair Oaks Blvd # 421
Sacramento, CA 95825-7684
Phone (916) 447-0490

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151019000991 CA Practitioner - Clinical Psychologist 3779892591 Practice locations: Sacramento, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2621 Capitol Ave
Sacramento, CA 95816-5920
Phone (916) 447-0490

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY8891CAMDPsychologist
8891CAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1104856202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2443 FAIR OAKS BLVD # 421",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958257684",
            "telephone_number": "916-447-0490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3560 J STREET, #6",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95816",
            "telephone_number": "916-447-0490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERO",
        "first_name": "CAROL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY8891",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY8891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.