Jacqueline Denise Rivera, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

16755 Issued in HI

Practice address

14-3335 Mayzee Rd # 2314
Pahoa, HI 96778-8171

Phone

(808) 365-2683

NPI assigned

Jun 27, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1561593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561593600000",
    "number": "1245891324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14-3335 MAYZEE RD # 2314",
            "city": "PAHOA",
            "state": "HI",
            "postal_code": "967788171",
            "telephone_number": "808-365-2683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14-3335 MAYZEE RD # 2314",
            "city": "PAHOA",
            "state": "HI",
            "postal_code": "967788171",
            "telephone_number": "808-365-2683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "JACQUELINE",
        "middle_name": "DENISE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-27",
        "last_updated": "2019-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "HI",
            "license": "16755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Penny Rice, L.AC.
• Ridge James Riley, MFT INTERN
• Candee Dione Rillon
• Richard Rimer, D.O.
• Hannah Brown Risko, RBT
• Tanya C Roberts, LMT
• Gregory Shawn Robichaud, DC
• Rani Nicole Roby
• Jake Rolbiecki, ATC, MS
• Pamela Roldan-Thomas

• Licensed Practical Nurse in Pahoa, HI
• Providers in Pahoa, HI by specialty
• Licensed Practical Nurse in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2019; 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.