Provider Demographics
NPI:1720400203
Name:BARRON, VIVIANA MARIA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:VIVIANA
Middle Name:MARIA
Last Name:BARRON
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:URB. HOLLYWOOD ESTATES HOLLYWOOD DRIVE #10
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-298-5782
Mailing Address - Fax:
Practice Address - Street 1:201 CALLE TETUAN # 8
Practice Address - Street 2:OLD SAN JUAN
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00901-1816
Practice Address - Country:US
Practice Address - Phone:787-298-5782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-17
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5393103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical