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General NPI Number Information
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NPI Number | 1255455762
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Entity Type | Individual
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Provider Name | DESIREE RIVERA PH.D.
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Gender | Female
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 421 AVE MUNOZ RIVERA MIDTOWN BLDG, SUITE 412
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City | SAN JUAN
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State | PR
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Zip | 00918-3416
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Country | US
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Telephone | 787-765-4358
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 AVE LOS ROMEROS APT 907 JARDINES DE MONTEHIEDRA
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City | SAN JUAN
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State | PR
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Zip | 00926
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Country | US
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Telephone | 787-248-9344
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 2287
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License Number State | PR
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