Provider Demographics
NPI:1003003914
Name:RIVERA LLUVERAS, KENIA MARI (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KENIA
Middle Name:MARI
Last Name:RIVERA LLUVERAS
Suffix:
Gender:F
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:CALLE 9 NUM. I 13 VISTA BELLA
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00956 4838
Mailing Address - Country:UM
Mailing Address - Phone:787-598-2415
Mailing Address - Fax:
Practice Address - Street 1:CARR. 21 S3 LAS LOMAS BO. MONACILLOS
Practice Address - Street 2:OFFICE # 2
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00956
Practice Address - Country:US
Practice Address - Phone:787-598-2415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-25
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2792103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical