Active NPI
Jacer Rivera, P.T.
- Physical Therapist
- Menifee, CA
National Provider Identifier
1902052384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT29221
- Practice address
- 29960 Bay View Way
Menifee, CA 92584-7993 - Phone
- (714) 234-6305
- NPI assigned
- Aug 17, 2008
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT29221 | CA | Primary |
Addresses
Primary practice location
29960 Bay View Way
Menifee, CA 92584-7993
Mailing address
29960 Bay View Way
Menifee, CA 92584-7993
Phone (714) 234-6305
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29221 | CA | MD | Clinical Social Worker |
| PT29221 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1218931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602028800000",
"number": "1902052384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29960 BAY VIEW WAY",
"city": "MENIFEE",
"state": "CA",
"postal_code": "925847993",
"telephone_number": "714-234-6305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29960 BAY VIEW WAY",
"city": "MENIFEE",
"state": "CA",
"postal_code": "925847993",
"telephone_number": "714-234-6305"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA",
"first_name": "JACER",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-08-17",
"last_updated": "2020-10-07",
"certification_date": "2020-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT29221",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Menifee, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.