Provider Demographics
NPI:1063583102
Name:HERNANDEZ RIVERA, SONIA I (PHD)
Entity type:Individual
Prefix:DR
First Name:SONIA
Middle Name:I
Last Name:HERNANDEZ RIVERA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:NH JACKSONVILLE 2080 CHILD ST JACKSONVILLE FL 32214
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32214-0001
Mailing Address - Country:US
Mailing Address - Phone:904-546-6351
Mailing Address - Fax:
Practice Address - Street 1:NH JACKSONVILLE 2080 CHILD ST JACKSONVILLE FL 32214
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32214-0001
Practice Address - Country:US
Practice Address - Phone:904-546-6351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-12
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2658103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical