Active NPI
Shane Rivera
- Addiction (Substance Use Disorder) Counselor
- Commerce, CA
National Provider Identifier
1487015707
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- Practice address
- 5053 Astor Ave
Commerce, CA 90040-1301 - Phone
- (323) 722-4529
- NPI assigned
- Mar 14, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CA | Primary |
Addresses
Primary practice location
5053 Astor Ave
Commerce, CA 90040-1301
Mailing address
5053 Astor Ave
Commerce, CA 90040-1301
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02768010 | Other | CA | DRUG MEDI-CAL |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1457913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1457913600000",
"number": "1487015707",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5053 ASTOR AVE",
"city": "COMMERCE",
"state": "CA",
"postal_code": "900401301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5053 ASTOR AVE",
"city": "COMMERCE",
"state": "CA",
"postal_code": "900401301",
"telephone_number": "323-722-4529"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA",
"first_name": "SHANE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-03-14",
"last_updated": "2016-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRUG MEDI-CAL",
"identifier": "02768010",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Commerce, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.