PAMELA JEAN RIVERA


Address: 15 Crater Lake Ave, Medford, OR 97504-7444
Phone: 5417705100

PAMELA JEAN RIVERA (NPI# 1558442061) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1558442061
Entity Type Individual
Full Name PAMELA JEAN RIVERA
Credential PMHNP
Practice Address 15 Crater Lake Ave
Medford
OR 97504-7444
Practice Telephone 5417705100
Practice Fax Number 5417705070
Mailing Telephone 5417705100
Mailing Fax Number 5417705070
Enumeration Date 2006-10-18
Last Update Date 2019-11-14
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP0808X Nurse Practitioner
Specialization: Psych/Mental Health
200650041NP OR Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
OR STATE NP LICENSE 200650041NP 01

Office Location

Street Address 15 CRATER LAKE AVE
City MEDFORD
State OR
Zip Code 97504-7444

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1255809109 Justin Blasdel Technician, Health Information 3250 Lone Pine Rd, Medford, OR 97504 2018-11-08
1396220133 Aimee K Michel Massage Therapist 3550 National Dr., Medford, OR 97504 2018-09-27
1437646908 Zola Dental Medford LLC Dentist 922 E Main, Medford, OR 97504 2018-04-19
1376068015 Megan Leggett Counselor 777 Murphy Road, Medford, OR 97504 2017-08-03
1023547536 Joshua Morgan Rice Dentist 1117 E Main St Ste 1, Medford, OR 97504 2017-06-08
1427580232 Paul James Dean Counselor 1175 Main St Ste 1c, Medford, OR 97504 2017-03-30
1811443542 Taya Adams Doula 1201 Progress Dr #90, Medford, OR 97504 2016-09-01
1174076228 Avalon Health Care - Hearthstone, LLC Skilled Nursing Facility 2091 E. Barnett Road, Medford, OR 97504 2016-07-25
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Taxonomy Information

Taxonomy Code 363LP0808X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Psych/Mental Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1073147716 Paradigm Mental Health and Wellness LLC Nurse Practitioner 724 S Central Ave Ste 101d, Medford, OR 97501-7808 2020-03-02
1952860066 Mcarthur, Gruff & Associates, LLC Dba Carmen Kosicek, Pmhnp Nurse Practitioner 1314b Center Dr Unit 439, Medford, OR 97501-7943 2019-03-18
1811246879 Deborra M. Torres, Msn, Pmhnp, LLC Nurse Practitioner 5 N Main St Ste A, Medford, NJ 08055-2439 2012-09-06
1518013705 Susan Wrona Nurse Practitioner 14 Cottage St, Medford, OR 97504-7332 2007-01-28
1164538096 Kevan Joyce Olson Nurse Practitioner 255 W Stewart Ave Ste 101, Medford, OR 97501-3600 2006-08-22
1851325252 Ruth E Koch Nurse Practitioner 31 Industrial Boulevard, Yaphank Center, Medford, NY 11763 2006-07-10
1174008536 Connie Diep Nurse Practitioner 26 City Hall Mall, Medford, MA 02155-4754 2018-10-01
1366927220 Helena Frances Turner Nurse Practitioner 900 E Main St, Medford, OR 97504-7136 2018-09-26
1265927974 Jatoopon Maldonado Nurse Practitioner 31 Scouting Blvd, Medford, NY 11763-2220 2018-06-25
1710487897 Paul Daniel Fickes Nurse Practitioner 2825 E Barnett Rd, Medford, OR 97504 2018-02-15
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Competitor

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City MEDFORD
Zip Code 97504

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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