Provider Demographics
NPI:1396419677
Name:RIVERA-RAMOS, ANDREA M (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:M
Last Name:RIVERA-RAMOS
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 1:130 CALLE YAGUEZ
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-3149
Mailing Address - Country:US
Mailing Address - Phone:787-215-1070
Mailing Address - Fax:
Practice Address - Street 1:URB. EL HIPODROMO CALLE AMERICA 1454
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00909
Practice Address - Country:US
Practice Address - Phone:787-215-1070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-02
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7052103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical