NPIMap

Organization Active NPI

Psicologia Avanzada LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Humacao, PR
National Provider Identifier
1912372889
Registry record updated May 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
3648 Issued in PR
Legal business name
PSICOLOGIA AVANZADA LLC
Practice address
Carr 908
Calle 26 Ba4 Bo. Tejas
Humacao, PR 00791-4056
Phone
(787) 852-9331
Fax
(787) 719-4681
NPI assigned
Dec 3, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2017

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

Authorized official

Name
Dr. Angel J Rivera Gomez, PSY. D.
Title
Presidente
Phone
(787) 852-9331

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 3648 PR Primary

Addresses

Primary practice location

Carr 908
Calle 26 Ba4 Bo. Tejas
Humacao, PR 00791-4056

Mailing address

Aa2 Ave Tejas
Correo Villa PMB 132
Humacao, PR 00791-4349
Phone (787) 852-9331

National Provider Directory

National Provider Directory

Locations

BA4 Calle 26A
Humacao, PR 00791
Phone (787) 852-9331

Practitioners & affiliated clinicians

Practitioners 4

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": "1449100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494201600000",
    "number": "1912372889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "AA2 AVE TEJAS",
            "address_2": "CORREO VILLA PMB 132",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "007914349",
            "telephone_number": "787-852-9331",
            "fax_number": "787-719-4681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 908",
            "address_2": "CALLE 26 BA4 BO. TEJAS",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "007914056",
            "telephone_number": "787-852-9331",
            "fax_number": "787-719-4681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSICOLOGIA AVANZADA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-03",
        "last_updated": "2017-05-08",
        "status": "A",
        "authorized_official_last_name": "RIVERA GOMEZ",
        "authorized_official_first_name": "ANGEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENTE",
        "authorized_official_telephone_number": "787-852-9331",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY. D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "PR",
            "license": "3648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Humacao, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2017; 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.