Provider Demographics
NPI:1386681914
Name:RIVERA LOPEZ, MARIA DEL C. (MSW)
Entity Type:Individual
Prefix:MISS
First Name:MARIA DEL C.
Middle Name:
Last Name:RIVERA LOPEZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3415 AVE ALEJANDRINO
Mailing Address - Street 2:PARQUE SAN RAMON APDO 701
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-4961
Mailing Address - Country:US
Mailing Address - Phone:787-347-0716
Mailing Address - Fax:
Practice Address - Street 1:3415 AVE ALEJANDRINO
Practice Address - Street 2:PARQUE SAN RAMON APDO 701
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-4961
Practice Address - Country:US
Practice Address - Phone:787-347-0716
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR55021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR005-3107Medicare ID - Type UnspecifiedMEDICARE PART B