1649215724 NPI number — MRS. VICTORIA IRENE GYGER MA MFT

Table of content: MRS. VICTORIA IRENE GYGER MA MFT (NPI 1649215724)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649215724 NPI number — MRS. VICTORIA IRENE GYGER MA MFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GYGER
Provider First Name:
VICTORIA
Provider Middle Name:
IRENE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MA MFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GYGER
Provider Other First Name:
VICKI
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MA MFT
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1649215724
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8275 SO EASTERN
Provider Second Line Business Mailing Address:
SUITE 123
Provider Business Mailing Address City Name:
LAS VEGAS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89123
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-739-0469
Provider Business Mailing Address Fax Number:
702-990-8681

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8275 SO EASTERN
Provider Second Line Business Practice Location Address:
SUITE 123
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89123
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-739-0469
Provider Business Practice Location Address Fax Number:
702-990-8681
Provider Enumeration Date:
06/20/2006

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: 106H00000X , with the licence number:  0264 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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