Lisa Marie Rivera, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA65595 Issued in CA

Practice address

2350 Buhne St
Eureka, CA 95501-3238

Phone

(707) 443-4593

NPI assigned

Jan 7, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lrivera808144@direct.ochin.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Neighborhood Outreach Access to Health

  • Federally Qualified Health Center (FQHC)
  • Glendale, AZ
  • NPI 1326731555
  NPD
• Neighborhood Outreach Access to Health

  • Family Medicine Physician
  • Scottsdale, AZ
  • NPI 1942518550

  Multi-Specialty

  NPD

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

{
    "created_epoch": "1609977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749081600000",
    "number": "1467040204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 N ALMA SCHOOL RD STE 11",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852244354",
            "telephone_number": "602-762-8142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 BUHNE ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955013238",
            "telephone_number": "707-443-4593"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "312 N Alma School Rd Ste 11",
            "address_purpose": "LOCATION",
            "city": "Chandler",
            "state": "AZ",
            "postal_code": "852244354",
            "country_code": "US",
            "telephone_number": "602-762-8142",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-07",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "8720",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "8720",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "718429",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA65595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105817",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA LICENSE",
            "identifier": "PA65595",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pascale Rioux Oliver
• Jahmil Ali Rippy, SUDRC #18014
• Michael Ritter
• Roxanne Eileen Ritter
• Lance Rivas, PA
• Veronica Rivera
• Donald Ray Rivers, CADC II
• Gisele Radegonde Rivinus
• Lisa Robyn Rix
• Jackson Robbins

• Physician Assistant in Eureka, CA
• Providers in Eureka, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2025; 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.