1871805853 NPI number — DR. SONIA NIEVES SANTIAGO PHD

Table of content: DR. SONIA NIEVES SANTIAGO PHD (NPI 1871805853)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871805853 NPI number — DR. SONIA NIEVES SANTIAGO PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NIEVES SANTIAGO
Provider First Name:
SONIA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1871805853
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/29/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 43001 STE 247
Provider Second Line Business Mailing Address:
VILLAS DE RIO GRANDE
Provider Business Mailing Address City Name:
RIO GRANDE
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00976
Provider Business Mailing Address Country Code:
UM
Provider Business Mailing Address Telephone Number:
787-364-9036
Provider Business Mailing Address Fax Number:
787-887-7837

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
K2 CALLE 4 VILLAS DE RIO GRANDE
Provider Second Line Business Practice Location Address:
VILLAS DE RIO GRANDE
Provider Business Practice Location Address City Name:
RIO GRANDE
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00745-2823
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-887-7837
Provider Business Practice Location Address Fax Number:
787-887-7837
Provider Enumeration Date:
07/08/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  3791 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3791 . This is a "LICENCE OF PSYCHOLOGIST" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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