Juan Enrique Rivera Valenzuela

Primary specialty

Social WorkerTaxonomy code 104100000X

License

97692 Issued in CA

Practice address

3050 Beacon Blvd Ste 103
West Sacramento, CA 95691-3467

Phone

(916) 462-3100

NPI assigned

Mar 30, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1891373197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4156 CITATION DR",
            "city": "OLIVEHURST",
            "state": "CA",
            "postal_code": "959614902",
            "telephone_number": "530-845-4983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 BEACON BLVD STE 103",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956913467",
            "telephone_number": "916-462-3100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 Empire St",
            "address_purpose": "LOCATION",
            "city": "Fairfield",
            "state": "CA",
            "postal_code": "945335702",
            "country_code": "US",
            "telephone_number": "707-425-5744",
            "fax_number": "707-425-5162",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVERA VALENZUELA",
        "first_name": "JUAN",
        "middle_name": "ENRIQUE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-30",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "97692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Social Worker in West Sacramento, CA
• Providers in West Sacramento, CA by specialty
• Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; 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.