Individual provider Active NPI

Kenneth Cesar Rivera, CMT

  • Massage Therapist
  • Rocklin, CA
National Provider Identifier
1447985346
Registry record updated Jul 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
89427 Issued in CA
Practice address
5714 Lonetree Blvd
Rocklin, CA 95765-3734
Phone
(916) 259-2510
Fax
(916) 259-0073
NPI assigned
Jul 24, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 89427 CA Primary

Addresses

Primary practice location

5714 Lonetree Blvd
Rocklin, CA 95765-3734

Mailing address

5714 Lonetree Blvd
Rocklin, CA 95765-3734
Phone (916) 259-2510

Other identifiers 1

IdentifierTypeStateIssuer
89427OtherCACAMTC

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

State licenses

LicenseStateTypeSpecialty
89427CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1658620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658620800000",
    "number": "1447985346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5714 LONETREE BLVD",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "957653734",
            "telephone_number": "916-259-2510",
            "fax_number": "916-259-0073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5714 LONETREE BLVD",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "957653734",
            "telephone_number": "916-259-2510",
            "fax_number": "916-259-0073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "KENNETH",
        "middle_name": "CESAR",
        "credential": "CMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-24",
        "last_updated": "2022-07-24",
        "certification_date": "2022-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "89427",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAMTC",
            "identifier": "89427",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocklin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2022; 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.