Provider Demographics
NPI:1518151109
Name:GONZALEZ RIVERA, GRETCHEN J (MS,PSYD)
Entity Type:Individual
Prefix:DR
First Name:GRETCHEN
Middle Name:J
Last Name:GONZALEZ RIVERA
Suffix:
Gender:F
Credentials:MS,PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:10 FLAMINGO APARTMENTS
Mailing Address - Street 2:APTO. 6201
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959-4322
Mailing Address - Country:US
Mailing Address - Phone:787-410-6425
Mailing Address - Fax:
Practice Address - Street 1:355 AVE HOSTOS
Practice Address - Street 2:URB. ROOSEVELT
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-2322
Practice Address - Country:US
Practice Address - Phone:787-767-4076
Practice Address - Fax:787-767-4076
Is Sole Proprietor?:No
Enumeration Date:2007-08-28
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR1901103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical