Provider Demographics
NPI:1740656883
Name:RIVERA-MEJIA, CARLA M (PHD)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:M
Last Name:RIVERA-MEJIA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 PASEO SAN PABLO
Mailing Address - Street 2:ARTURO CADILLA BUILDING SUITE 401
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-7019
Mailing Address - Country:US
Mailing Address - Phone:787-786-7391
Mailing Address - Fax:
Practice Address - Street 1:100 PASEO SAN PABLO
Practice Address - Street 2:ARTURO CADILLA BUILDING SUITE 401
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-7019
Practice Address - Country:US
Practice Address - Phone:787-786-7391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-12
Last Update Date:2020-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4182103T00000X, 103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103T00000XBehavioral Health & Social Service ProvidersPsychologist