Provider Demographics
NPI:1255991493
Name:SANCHEZ RIVERA, JORGE E
Entity type:Individual
Prefix:
First Name:JORGE
Middle Name:E
Last Name:SANCHEZ RIVERA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2680 CALLE LAS CARROZAS
Mailing Address - Street 2:URB PERLA DEL SUR
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717
Mailing Address - Country:US
Mailing Address - Phone:939-254-5137
Mailing Address - Fax:
Practice Address - Street 1:2680 CALLE LAS CARROZAS
Practice Address - Street 2:URB PERLA DEL SUR
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717
Practice Address - Country:US
Practice Address - Phone:939-254-5137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-19
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR137671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical