Individual provider Active NPI

Liliana Mycala Rivero, MS

  • Marriage & Family Therapist
  • Colton, CA
National Provider Identifier
1386301745
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
AMFT150091 Issued in CA
Practice address
1325 E Cooley Dr Ste 112
Colton, CA 92324-3966
Phone
(909) 492-0573
NPI assigned
Nov 19, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Marriage & Family Therapist 106H00000X AMFT150091 CA Primary

Addresses

Primary practice location

1325 E Cooley Dr Ste 112
Colton, CA 92324-3966

Mailing address

PO Box 144
Redlands, CA 92373-0041
Phone (909) 645-4001

Other practice location 1

2155 Chicago Ave Ste 203
Riverside, CA 92507-2209
Phone (951) 357-6926

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
AMFT150091CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1637280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1386301745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 144",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923730041",
            "telephone_number": "909-645-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 E COOLEY DR STE 112",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923243966",
            "telephone_number": "909-492-0573"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2155 Chicago Ave Ste 203",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925072209",
            "country_code": "US",
            "telephone_number": "951-357-6926",
            "fax_number": "855-568-2494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVERO",
        "first_name": "LILIANA",
        "middle_name": "MYCALA",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-19",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT150091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; 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.