Nydia Iris Hernandez Rivera, PSIC IT-O

Primary specialty

PsychologistTaxonomy code 103T00000X

License

3567 Issued in PR

Practice address

205 Calle Juan San Antonio
Edificio Bposques
Moca, PR 00676-9617

Phone

(787) 364-4605

NPI assigned

Feb 11, 2007

Reactivated

Jun 3, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1171152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562889600000",
    "number": "1356482301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC-01 BOX 7066",
            "city": "MOCA",
            "state": "PR",
            "postal_code": "006769617",
            "telephone_number": "787-364-4605",
            "fax_number": "787-877-3696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 CALLE JUAN SAN ANTONIO",
            "address_2": "EDIFICIO BPOSQUES",
            "city": "MOCA",
            "state": "PR",
            "postal_code": "006769617",
            "telephone_number": "787-364-4605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ RIVERA",
        "first_name": "NYDIA",
        "middle_name": "IRIS",
        "name_prefix": "Ms.",
        "credential": "PSIC IT-O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-11",
        "last_updated": "2019-07-12",
        "deactivation_date": "2007-07-17",
        "reactivation_date": "2010-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PR",
            "license": "795",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PR",
            "license": "3567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ines Marie Hernandez Arbelo, MD
• Rene E Hernandez Cordero, MD
• Jamalie Hernandez de la Cruz, PS.L
• Illiad E Hernandez Lopez, T M
• Anaitsi Hernandez Mendoza, LND
• Yelitza Hernandez Soto
• Lidibeth Hernandez Villanueva, RN
• Savier Hernandez-Cordero, P.T.
• Abigail Hernandez, P.T.
• Cynthia Hernandez

• Psychologist in Moca, PR
• Providers in Moca, PR by specialty
• Psychologist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2019; 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.