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General NPI Number Information
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NPI Number | 1376955666
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Entity Type | Organization
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Legal Business Name | VIVA CLINIC P.S.C.
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Dates
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Enumeration Date | 05/21/2014
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Last Update Date | 05/21/2014
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Provider Practice Location Address
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Address Line | 201 CALLE TETUAN # 8 OLD SAN JUAN
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City | SAN JUAN
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State | PR
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Zip | 00901-1816
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Country | US
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Telephone | 787-552-7676
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Fax |
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Provider Business Mailing Address
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Address Line | 201 A CALLE TETUAN PISO #8 BO VIEJO SAN JUAN
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City | SAN JUAN
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State | PR
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Zip | 00901
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Country | US
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Telephone | 787-552-7676
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | DR. VIVIANA M BARRON
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Credential | PSY. D.
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Telephone | 787-552-7676
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 5601
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 5393
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License Number State | PR
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