1245690452 NPI number — JOHANA ALBARRACIN BA DEGREE IN PSYCHOL

Table of content: JOHANA ALBARRACIN BA DEGREE IN PSYCHOL (NPI 1245690452)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245690452 NPI number — JOHANA ALBARRACIN BA DEGREE IN PSYCHOL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALBARRACIN
Provider First Name:
JOHANA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
BA DEGREE IN PSYCHOL
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ALBARRACIN SANCHEZ
Provider Other First Name:
JOHANA
Provider Other Middle Name:
MARIA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
BA IN PHSYCHOLOGY
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1245690452
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/01/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5145 RAWHIDE ST
Provider Second Line Business Mailing Address:
APT 146
Provider Business Mailing Address City Name:
LAS VEGAS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89122-4801
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-272-3699
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5145 RAWHIDE ST
Provider Second Line Business Practice Location Address:
APT 146
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89122-4801
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-272-3699
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/01/2016

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: 225400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1704933411 , issued by the state of ( NV ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com