Individual provider Active NPI

Yalizeth Katiuska Rivera Gonzalez

  • Psychologist
  • Mayaguez, PR
National Provider Identifier
1033717343
Registry record updated Oct 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6693 Issued in PR
Practice address
Carr 348 KM 7.2
Bo Rosario
Mayaguez, PR 00680
Phone
(787) 429-4576
NPI assigned
Oct 9, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6693 PR Primary

Addresses

Primary practice location

Carr 348 KM 7.2
Bo Rosario
Mayaguez, PR 00680

Mailing address

HC 2 Box 23690
Mayaguez, PR 00680-9032
Phone (787) 429-4576

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6693PRMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1602201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602201600000",
    "number": "1033717343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 2 BOX 23690",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006809032",
            "telephone_number": "787-429-4576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 348 KM 7.2",
            "address_2": "BO ROSARIO",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "00680",
            "telephone_number": "787-429-4576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA GONZALEZ",
        "first_name": "YALIZETH",
        "middle_name": "KATIUSKA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-09",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PR",
            "license": "6693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayaguez, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.