Provider Demographics
NPI:1154048254
Name:CASTA RIVAS, ROSALINA
Entity type:Individual
Prefix:MISS
First Name:ROSALINA
Middle Name:
Last Name:CASTA RIVAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5153
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-5153
Mailing Address - Country:US
Mailing Address - Phone:787-370-3770
Mailing Address - Fax:
Practice Address - Street 1:PLAZA SALUD SANOS AVE RAFAEL CORDERO
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-0072
Practice Address - Country:US
Practice Address - Phone:787-747-1374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-20
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR22793104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker