Provider Demographics
NPI:1386458388
Name:RIVERA, ALEXANDRA (MA)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:RIVERA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22391 ROSEBRIAR
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-4615
Mailing Address - Country:US
Mailing Address - Phone:949-633-6054
Mailing Address - Fax:
Practice Address - Street 1:1441 SUPERIOR AVE STE A
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-2700
Practice Address - Country:US
Practice Address - Phone:949-393-2240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-03
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach