Healthcare Provider Details

I. General information

NPI: 1619852803
Provider Name (Legal Business Name): YOLANDA ENID ROVIRA PEREIRA MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2025
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

562 CALLE BERWIN
SAN JUAN PR
00920-4303
US

IV. Provider business mailing address

562 CALLE BERWIN
SAN JUAN PR
00920-4303
US

V. Phone/Fax

Practice location:
  • Phone: 787-671-9557
  • Fax:
Mailing address:
  • Phone: 787-671-9557
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number8283
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: