Healthcare Provider Details

I. General information

NPI: 1205742418
Provider Name (Legal Business Name): GISELLE ANDRADE PACHECO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 N WALSH ST
CARSON CITY NV
89701-4268
US

IV. Provider business mailing address

407 N WALSH ST
CARSON CITY NV
89701-4268
US

V. Phone/Fax

Practice location:
  • Phone: 775-298-6386
  • Fax: 775-418-7636
Mailing address:
  • Phone: 775-298-6386
  • Fax: 775-418-7636

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number11038-M
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: