MEDICARE: VANESSA ANN QUIMING MARTINEZ

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
1	1041C0700X	Clinical Social Worker	9952-M	NV

General Provider Information

NPI Number	:	1780183061
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANESSA ANN QUIMING MARTINEZ

Provider Business Mailing Address
First Line	:	1778 BLUE RIBBON DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89142-0737
Country	:	US
Telephone Number	:	702-472-2848
Fax Number	:

Provider Business Practice Location Address
First Line	:	2320 PASEO DEL PRADO STE B208
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-4332
Country	:	US
Telephone Number	:	702-685-0877
Fax Number	:	702-749-5922

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2018
Last Update Date	:	03/26/2024

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Directions to “ VANESSA ANN QUIMING MARTINEZ ” Practice Location

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