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NPI Code Detail

MEDICARE: JARITZA SIERRA

MEDICARE:   JARITZA  SIERRA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2102L00000XPsychoanalyst

General Provider Information

NPI Number : 1669092052
Entity Type Code : Individual
Provider Name (Legal Business Name) : JARITZA SIERRA
Provider Business Mailing Address
First Line : 4170 S DECATUR BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89103-5861
Country : US
Telephone Number : 702-659-8827
Fax Number :
Provider Business Practice Location Address
First Line : 4170 S DECATUR BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89103-5861
Country : US
Telephone Number : 702-659-8827
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2020
Last Update Date : 03/02/2021

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Directions to “ JARITZA SIERRA ” Practice Location

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