Provider Demographics
NPI:1528811239
Name:RIVERA, JEREMIAS
Entity type:Individual
Prefix:
First Name:JEREMIAS
Middle Name:
Last Name:RIVERA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1663 MISSION ST STE 603
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-2473
Mailing Address - Country:US
Mailing Address - Phone:415-568-6469
Mailing Address - Fax:
Practice Address - Street 1:1663 MISSION ST STE 603
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2473
Practice Address - Country:US
Practice Address - Phone:415-568-6469
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor