Individual provider Active NPI

Desiree Rivera, MS, AMFT

  • Mental Health Counselor
  • Oceanside, CA
National Provider Identifier
1659049815
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
R6910 Issued in OR
Practice address
2103 S El Camino Real Ste 206
Oceanside, CA 92054-6281
Phone
(442) 500-8548
Fax
(760) 400-8379
NPI assigned
Sep 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X R6910 OR Primary

Addresses

Primary practice location

2103 S El Camino Real Ste 206
Oceanside, CA 92054-6281

Mailing address

PO Box 22853
Milwaukie, OR 97269-2853
Phone (442) 500-8548

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
R6910ORMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Willow Tree Licensed Clinical Social Worker CurrentSince Aug 4, 2024 Accepting new patients
Pug Therapy CurrentSince Sep 5, 2021 Accepting new patients

Locations

2103 S El Camino Real
Ste 206
Oceanside, CA 92054
Phone (442) 245-7097

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1630540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1659049815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22853",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972692853",
            "telephone_number": "442-500-8548",
            "fax_number": "760-400-8379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2103 S EL CAMINO REAL STE 206",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920546281",
            "telephone_number": "442-500-8548",
            "fax_number": "760-400-8379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "DESIREE",
        "credential": "MS, AMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-02",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "R6910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; 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.