Organization Name: | JESSICA E. RIVERA PSY.D. P.A. |
NPI Number: | 1265709521 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JESSICA RIVERA (PRESIDENET) |
Mailing Address: | 11820 Miramar Pkwy Ste 111 Miramar |
State: | FL US |
Postal Code: | 330255816 |
Phone Number: | 9549338299 |
Fax Number: | |
NPI Enumeration Date: | 11/30/2011 |
NPI Last Update Date: | 02/05/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | PY8359 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Clinical Neuropsychologist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |