Rivera, Gerson O

Rivera, Gerson O is an individual health care provider with primary practice located at 8280 Willow Oaks Corporate Dr Ste 600 , Fairfax VA 22031-4516. He recently has 2 registered licenses in different health care specialties including Nursing Service Related Providers / Technician, Behavioral Health & Social Service Providers / Behavior Technician. Behavioral Health & Social Service Providers / Behavior Technician is his primary health care specialty. Rivera, Gerson O can be contacted via phone (888) 922-2843.

Contact Information

Primary practice address
8280 Willow Oaks Corporate Dr Ste 600 Fairfax VA 22031-4516
Phone: (888) 922-2843
Fax: (855) 568-2494
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Related Providers / Technician 374700000X
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X

Profile Details

NPI number 1669196945
LBN Legal business name Rivera, Gerson O
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 29th, 2022
Last updated Sep 30th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669196945 NPPES
Virginia MEDICAID 000678439

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