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General NPI Number Information
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NPI Number | 1417260043
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Entity Type | Individual
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Provider Name | JOSE LUIS PAGAN RIVERA PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 07/25/2010
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | AVE HOSTOS # 8
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City | MAYAGUEZ
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State | PR
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Zip | 00682-6353
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Country | US
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Telephone | 787-649-7730
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Fax | 787-832-6249
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Provider Business Mailing Address
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Address Line | URB. HOSTOS #8 LUIS DECELIS
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City | MAYAGUEZ
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State | PUERTO RICO
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Zip | 00682
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Country | UM
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Telephone |
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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 | 3615
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License Number State | PR
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