Provider Demographics
NPI:1053779645
Name:ALVAREZ-TORRES, VIVIAN (PSYD)
Entity type:Individual
Prefix:DR
First Name:VIVIAN
Middle Name:
Last Name:ALVAREZ-TORRES
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. ALTA VISTA
Mailing Address - Street 2:EROS 2003
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716-2203
Mailing Address - Country:US
Mailing Address - Phone:413-519-3964
Mailing Address - Fax:
Practice Address - Street 1:URB. ALTA VISTA
Practice Address - Street 2:EROS 2003
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-2203
Practice Address - Country:US
Practice Address - Phone:413-519-3964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-10
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
PR6458103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM18463OtherBLUE CROSS BLUE SHIELD
MA1303295Medicaid
MA1307576Medicaid
MA1307576Medicaid