Provider Demographics
NPI:1295619526
Name:RIOS, KIMBERLY (MA, LPSYCH)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:RIOS
Suffix:
Gender:F
Credentials:MA, LPSYCH
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:
Other - Last Name:RIOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LPSYCH
Mailing Address - Street 1:G3 URB BRISAS DE CAMUY
Mailing Address - Street 2:
Mailing Address - City:CAMUY
Mailing Address - State:PR
Mailing Address - Zip Code:00627-2210
Mailing Address - Country:US
Mailing Address - Phone:939-269-5910
Mailing Address - Fax:
Practice Address - Street 1:G3 URB BRISAS DE CAMUY
Practice Address - Street 2:
Practice Address - City:CAMUY
Practice Address - State:PR
Practice Address - Zip Code:00627-2210
Practice Address - Country:US
Practice Address - Phone:939-269-5910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-31
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7849103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist