| Doctor Name: | DR. SANDRA RIVERA |
| NPI Number: | 1730474875 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSYD |
| License Number: | 4036 |
| Business Practice Address: | Hc 02 Box 6110 Macana La Vega Penuelas, PUERTO RICO - 00624 |
| Business Phone Number: | 7879309264 |
| Business Fax Number: | 7878364091 |
| Mailing Address: | Hc 02 Box 6110, Macana La Vega PENUELAS |
| State: | PUERTO RICO |
| Postal Code: | 00624 |
| Phone Number: | 7879309264 |
| Fax Number: | 7878364091 |
| NPI Enumeration Date: | 06/16/2011 |
| NPI Last Update Date: | 06/16/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 4036 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |