Doctor Name: | OBIANUJU RIVERA |
NPI Number: | 1003104167 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 20775 |
Business Practice Address: | 200 S Wells Rd Ste 100 Ventura, CA - 930041378 |
Business Phone Number: | 8056476322 |
Business Fax Number: | |
Mailing Address: | 5151 W Wooley Rd, OXNARD |
State: | CA |
Postal Code: | 930351829 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 07/11/2011 |
NPI Last Update Date: | 08/04/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 20775 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |