Provider Demographics
NPI:1730061250
Name:RIVERA, MARITZA ISABEL (FNP)
Entity type:Individual
Prefix:
First Name:MARITZA
Middle Name:ISABEL
Last Name:RIVERA
Suffix:
Gender:X
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:439 W MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:COMPTON
Mailing Address - State:CA
Mailing Address - Zip Code:90220-2055
Mailing Address - Country:US
Mailing Address - Phone:310-213-2766
Mailing Address - Fax:
Practice Address - Street 1:439 W MAPLE ST
Practice Address - Street 2:
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90220-2055
Practice Address - Country:US
Practice Address - Phone:310-213-2766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95033948363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily