| Doctor Name: | MRS. LYNETTE J. RIVINIUS |
| NPI Number: | 1710123237 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN, MS, CNS, CDE |
| License Number: | 260455 |
| Business Practice Address: | 22552 Lark St Grand Terrace, CA - 923135716 |
| Business Phone Number: | 9093804397 |
| Business Fax Number: | |
| Mailing Address: | 22552 Lark St, GRAND TERRACE |
| State: | CA |
| Postal Code: | 923135716 |
| Phone Number: | 9093804397 |
| Fax Number: | |
| NPI Enumeration Date: | 01/06/2009 |
| NPI Last Update Date: | 01/06/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WD0400X |
| License Number: | 260455 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Diabetes Educator |
| Taxonomy Definition: | |