Provider Demographics
NPI:1437575560
Name:CAPPA, NIVLEM (PH D)
Entity type:Individual
Prefix:DR
First Name:NIVLEM
Middle Name:
Last Name:CAPPA
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB PEREZ MORRIS
Mailing Address - Street 2:79 PONCE STREET
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00917-5007
Mailing Address - Country:US
Mailing Address - Phone:787-209-9568
Mailing Address - Fax:
Practice Address - Street 1:79 CALLE PONCE
Practice Address - Street 2:URB PEREZ MORRIS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-5007
Practice Address - Country:US
Practice Address - Phone:787-209-9568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-13
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR005219103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical