Vegas Innovative Psychiatry (NPI# 1053931576) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider Identifier (NPI) | 1053931576 |
| Entity Type | Organization |
| Organization Name | VEGAS INNOVATIVE PSYCHIATRY |
| Practice Address |
2021 Paseo Del Prado Suite A 120 Las Vegas NV 89102-0045 |
| Practice Telephone | 7025801850 |
| Mailing Address |
2021 Paseo Del Prado Suite A 120 Las Vegas NV 89102-0045 |
| Mailing Telephone | 7025801850 |
| Authorized Official Name | Maria Fernanda Mitchell (PROGRAM DIRECTOR) |
| Authorized Official Telephone | 7025801850 |
| Organization Subpart | No, this organization is not a Subpart |
| Enumeration Date | 2020-04-24 |
| Last Update Date | 2020-04-24 |
| Primary | Taxonomy | Classification | Taxonomy Group | License Number | State |
|---|---|---|---|---|---|
| Yes | 261QM1300X | Clinic/Center · Multi-Specialty | Ambulatory Health Care Facilities |
| State | Identifier | Issuer | Type Code |
|---|---|---|---|
| NV | E6055912020-0 | MEDICAID |
| Other Name | Type Code |
|---|---|
| Vegas Innovative Psychiatry | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558981068 | Vegas Innovative Psychiatry | Psychologist | 1721 E Charleston Blvd, Las Vegas, NV 89104-1902 | 2020-04-24 |
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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| 1942829346 | Elite Md | Clinic/Center | 2855 S Bronco St, Las Vegas, NV 89146-5207 | 2020-04-15 |
| 1356806319 | Nevada Mercy and Care Inc | Clinic/Center | 4440 S Eastern Ave, Las Vegas, NV 89119-7825 | 2019-02-04 |
| Find all providers in LAS VEGAS | ||||
| Street Address |
2021 PASEO DEL PRADO SUITE A 120 |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89102-0045 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922629765 | Bianca Vaudreuil | Religious Nonmedical Practitioner | 3210 W Charleston Ste 2, Las Vegas, NV 89102 | 2020-05-04 |
| 1720608052 | Angelica Gutierrez | Technician | Vegas Compassionate Care ; 2820 W. Charleston Blvd B-21, Las Vegas, NV 89102 | 2020-04-16 |
| 1396370680 | Juana Maria Hernandez | Technician | 2881 S. Valley View Blvd, Suite #6, Las Vegas, NV 89102 | 2020-03-06 |
| 1609409648 | Janie Washington | Technician | 3210 W Charleston Blvd. Suite 2, Las Vegas, NV 89102 | 2020-02-18 |
| 1447893185 | Maria Josefina Castaneda | Technician | 2881 S. Valley View Blvd Suite #6, Los Vegas, NV 89102 | 2019-10-25 |
| 1427608777 | Virginia Hernandez Tolentino | Technician | 4550 W Oakley Blvd, Suite 101 A, Las Vegas, NV 89102 | 2019-09-18 |
| 1972153872 | Gladiola Cardoza Quinones | Technician | 2881 S. Valley View Blvd #6, Las Vegas, NV 89102 | 2019-09-13 |
| 1801445572 | Rafael Roberto Gonzalez Palomino | Homemaker | 4550 W. Oakey Blvd, Suite 111-0, Las Vegas, NV 89102 | 2019-09-05 |
| 1780232694 | Juan Manuel Perez Reyes | Technician | 4117 El Parque Ave, Las Vegas, NV 89102 | 2019-09-04 |
| 1205484979 | Veronica Robles Contreras | Technician | 2881 S Valley View Blvd Suite #6, Las Vegas, NV 89102 | 2019-08-27 |
| Find all providers in zip 89102 | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.