| Rivera Behavioral Health Pllc | |
|
12915 Jones Maltsberger Rd Ste 300 San Antonio TX 78247-4255 | |
| (210) 802-7759 | |
| Not Available |
| Full Name | Rivera Behavioral Health Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 12915 Jones Maltsberger Rd Ste 300, San Antonio, Texas |
| Authorized Official Name and Position | Krystle Rivera (OWNER/OPERATOR) |
| Authorized Official Contact | 2108027759 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rivera Behavioral Health Pllc Po Box 701413 San Antonio TX 78270-1413 Ph: (210) 802-7759 | Rivera Behavioral Health Pllc 12915 Jones Maltsberger Rd Ste 300 San Antonio TX 78247-4255 Ph: (210) 802-7759 |
| NPI Number | 1083484596 |
|---|---|
| Provider Enumeration Date | 01/05/2024 |
| Last Update Date | 01/05/2024 |
| Certification Date | 01/05/2024 |
| Medicare PECOS PAC ID | 9335583186 |
|---|---|
| Medicare Enrollment ID | O20240220002305 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083484596 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Krystle J Rivera |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1679998215 PECOS PAC ID: 8820316805 Enrollment ID: I20150423002019 |
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