Provider Demographics
NPI:1316709330
Name:RIVERA-VILLEGAS, ANGELICA (MS)
Entity type:Individual
Prefix:
First Name:ANGELICA
Middle Name:
Last Name:RIVERA-VILLEGAS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 CALLE BENITEZ CASTANO
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00911-2217
Mailing Address - Country:US
Mailing Address - Phone:787-403-3453
Mailing Address - Fax:
Practice Address - Street 1:14 CALLE GEORGETTI
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00925-3606
Practice Address - Country:US
Practice Address - Phone:787-403-3453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)