Provider Demographics
NPI:1093999823
Name:RIVERA-ALICEA, JUAN A (PSYD)
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:A
Last Name:RIVERA-ALICEA
Suffix:
Gender:
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CARR. 156 BO. RIO HONDO
Mailing Address - Street 2:URB SABANA DEL PALMAR
Mailing Address - City:COMERIO
Mailing Address - State:PR
Mailing Address - Zip Code:00782
Mailing Address - Country:US
Mailing Address - Phone:939-280-7455
Mailing Address - Fax:
Practice Address - Street 1:CARR. 156 BO. RIO HONDO
Practice Address - Street 2:URB SABANA DEL PALMAR
Practice Address - City:COMERIO
Practice Address - State:PR
Practice Address - Zip Code:00782
Practice Address - Country:US
Practice Address - Phone:939-280-7455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-28
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1823103TC0700X
IA115791103TC0700X
PR2891103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical