Provider Demographics
NPI:1588870240
Name:RIVERA, MARIA L (PHD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:L
Last Name: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:UNIVERSITY OF PUERTO RICO MEDICAL SCIENCES CAMPUT
Mailing Address - Street 2:DEPARTMENT OF PSYCHIATRY 9TH FLOOR
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-5067
Mailing Address - Country:US
Mailing Address - Phone:787-600-3115
Mailing Address - Fax:787-764-7004
Practice Address - Street 1:UNIVERSITY OF PUERTO RICO MEDICAL SCIENCES CAMPUS
Practice Address - Street 2:DEPARTMENT OF PSYCHIATRY 9TH FLOOR
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00935
Practice Address - Country:US
Practice Address - Phone:787-766-0940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2023-08-28
Deactivation Date:2023-04-05
Deactivation Code:
Reactivation Date:2023-08-10
Provider Licenses
StateLicense IDTaxonomies
PR1743103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical