Individual provider Active NPI

Santiago Rivera-Santos, PH. D.

  • Clinical Psychologist
  • San Juan, PR
National Provider Identifier
1629205463
Registry record updated Jun 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3398 Issued in PR
Practice address
255 Calle Tetuan
Apt. 9 Old SJ
San Juan, PR 00901-1959
Phone
(939) 628-9484
NPI assigned
Jun 19, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2009

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Psychologist 103TA0400X 3398 PR
Adult Development & Aging Psychologist 103TA0700X 3398 PR
Cognitive & Behavioral Psychologist 103TB0200X 3398 PR
Clinical Psychologist 103TC0700X 3398 PR Primary
Clinical Child & Adolescent Psychologist 103TC2200X 3398 PR
Forensic Psychologist 103TF0200X 3398 PR
Health Service Psychologist 103TH0100X 3398 PR

Addresses

Primary practice location

255 Calle Tetuan
Apt. 9 Old SJ
San Juan, PR 00901-1959

Mailing address

255 Calle Tetuan
Apt. 9 Old SJ
San Juan, PR 00901-1959
Phone (939) 628-9484

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
3398PRMDAddiction (Substance Use Disorder) Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1245369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245369600000",
    "number": "1629205463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 CALLE TETUAN",
            "address_2": "APT. 9 OLD SJ",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009011959",
            "telephone_number": "939-628-9484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 CALLE TETUAN",
            "address_2": "APT. 9 OLD SJ",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009011959",
            "telephone_number": "939-628-9484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA-SANTOS",
        "first_name": "SANTIAGO",
        "name_prefix": "Dr.",
        "credential": "PH. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-19",
        "last_updated": "2009-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "PR",
            "license": "3398",
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "PR",
            "license": "3398",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "PR",
            "license": "3398",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "3398",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "PR",
            "license": "3398",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "PR",
            "license": "3398",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "PR",
            "license": "3398",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2009; 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.