Individual provider Active NPI

Diana Rivera

  • Clinical Psychologist
  • Los Angeles, CA
National Provider Identifier
1881025286
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY32485 Issued in CA
Practice address
5066 Eagle Rock Blvd Ste G
Los Angeles, CA 90041-3904
Phone
(310) 801-7399
NPI assigned
Dec 10, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY32485 CA Primary

Addresses

Primary practice location

5066 Eagle Rock Blvd Ste G
Los Angeles, CA 90041-3904

Mailing address

5066 Eagle Rock Blvd Ste G
Los Angeles, CA 90041-3904
Phone (310) 801-7399

Other identifiers 1

IdentifierTypeStateIssuer
01261511MedicaidCA

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
PSY32485CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerment Psychology, a Professional Psychology Corporation CurrentSince Jul 1, 2021 Accepting new patients
Paula E. Bruce, PH.D. & Associates, a Psychological Corporation Clinical Past Accepting new patients

Locations

5066 Eagle Rock Blvd
Ste G
Los Angeles, CA 90041
Phone (310) 801-7399

2900 Riverside Dr
Los Angeles, CA 90039
Phone (949) 680-7267

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1386633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1881025286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5066 EAGLE ROCK BLVD STE G",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900413904",
            "telephone_number": "310-801-7399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5066 EAGLE ROCK BLVD STE G",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900413904",
            "telephone_number": "310-801-7399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "DIANA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-10",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY32485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01261511",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.