Healthcare Provider Details

I. General information

NPI: 1952065187
Provider Name (Legal Business Name): YESENIA VARGAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2021
Last Update Date: 10/25/2021
Certification Date: 10/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1665 OLD HOT SPRINGS RD STE 150
CARSON CITY NV
89706-0668
US

IV. Provider business mailing address

727 FAIRVIEW DR STE A
CARSON CITY NV
89701-5493
US

V. Phone/Fax

Practice location:
  • Phone: 775-687-0870
  • Fax: 775-687-5103
Mailing address:
  • Phone: 775-684-5000
  • Fax: 775-684-1181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: