NPIMap

Organization Active NPI

Innova Psychological Group, LLC

  • Clinical Psychologist
  • Dorado, PR
National Provider Identifier
1861057580
Registry record updated May 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
INNOVA PSYCHOLOGICAL GROUP, LLC
Practice address
Carr 695 KM 2.0
Bo Higuillar
Dorado, PR 00646
Phone
(787) 315-6034
NPI assigned
May 8, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2021

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

Authorized official

Name
Dr. Juan A Gonzalez Rivera, PSY.D.NPI 1285128447
Title
Administrator
Phone
(939) 545-5241

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

Carr 695 KM 2.0
Bo Higuillar
Dorado, PR 00646

Mailing address

500 Ave West Main Apt 215
Bayamon, PR 00961-3875
Phone (787) 315-6034

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1557273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621468800000",
    "number": "1861057580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 AVE WEST MAIN APT 215",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009613875",
            "telephone_number": "787-315-6034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 695 KM 2.0",
            "address_2": "BO HIGUILLAR",
            "city": "DORADO",
            "state": "PR",
            "postal_code": "00646",
            "telephone_number": "787-315-6034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVA PSYCHOLOGICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-08",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ RIVERA",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "939-545-5241",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorado, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2021; 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.