Healthcare Provider Details

I. General information

NPI: 1669104378
Provider Name (Legal Business Name): ANGEL E ALEMAN RIVERA PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2022
Last Update Date: 11/24/2023
Certification Date: 11/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 CALLE JUAN F CORTES SUITE 2
SAN SEBASTIAN PR
00685-4808
US

IV. Provider business mailing address

2 CALLE JUAN F CORTES SUITE 2
SAN SEBASTIAN PR
00685-4808
US

V. Phone/Fax

Practice location:
  • Phone: 787-280-3567
  • Fax:
Mailing address:
  • Phone: 787-415-1390
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number7111
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number7111
License Number StatePR
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number7111
License Number StatePR
# 4
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number7111
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: