Provider Demographics
NPI:1174978704
Name:RIVERA, CELINE (LMFT145896)
Entity type:Individual
Prefix:MISS
First Name:CELINE
Middle Name:
Last Name:RIVERA
Suffix:
Gender:F
Credentials:LMFT145896
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14071 PEYTON DR UNIT 35
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-7101
Mailing Address - Country:US
Mailing Address - Phone:626-776-4604
Mailing Address - Fax:
Practice Address - Street 1:1126 N GRAND AVE
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91724-1551
Practice Address - Country:US
Practice Address - Phone:626-776-4604
Practice Address - Fax:626-967-6027
Is Sole Proprietor?:No
Enumeration Date:2016-05-02
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT124830101YM0800X
CALMFT145896106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health