Provider Demographics
NPI:1396965620
Name:RIVERA, ERIKA MARIA (PSYCHOLOGIST)
Entity type:Individual
Prefix:MS
First Name:ERIKA
Middle Name:MARIA
Last Name:RIVERA
Suffix:
Gender:F
Credentials:PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:STREET 9,JOVELLANOS
Mailing Address - Street 2:1D5, URB. COVADONGA
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949
Mailing Address - Country:US
Mailing Address - Phone:787-740-4685
Mailing Address - Fax:
Practice Address - Street 1:CALLE # 9
Practice Address - Street 2:1D5, URB. COVADONGA
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949
Practice Address - Country:US
Practice Address - Phone:787-740-4685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2033103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist