Provider Demographics
NPI:1306059183
Name:RODRIGUEZ RIOS, RAIZA J (PSY D)
Entity type:Individual
Prefix:
First Name:RAIZA
Middle Name:J
Last Name:RODRIGUEZ RIOS
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86103 CALLE MONTE LLANO
Mailing Address - Street 2:URB. MONTE CLARO
Mailing Address - City:GUAYANILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00656
Mailing Address - Country:US
Mailing Address - Phone:787-310-5661
Mailing Address - Fax:
Practice Address - Street 1:PLAZA SAN CRISTOBAL
Practice Address - Street 2:SEGUNDO PISO
Practice Address - City:COTO LAUREL
Practice Address - State:PR
Practice Address - Zip Code:00780
Practice Address - Country:US
Practice Address - Phone:787-318-8359
Practice Address - Fax:787-842-4071
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2805103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist