Provider Demographics
NPI:1831461292
Name:ALVAREZ NIEVES, LYSANDRA (PSY D)
Entity Type:Individual
Prefix:DR
First Name:LYSANDRA
Middle Name:
Last Name:ALVAREZ NIEVES
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1698 CALLE CUERNAVACA
Mailing Address - Street 2:VENUS GARDENS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-4728
Mailing Address - Country:US
Mailing Address - Phone:787-236-0107
Mailing Address - Fax:
Practice Address - Street 1:1698 CALLE CUERNAVACA
Practice Address - Street 2:VENUS GARDENS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-4728
Practice Address - Country:US
Practice Address - Phone:787-236-0107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-01
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3845103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical