Healthcare Provider Details

I. General information

NPI: 1659828325
Provider Name (Legal Business Name): MARIO MAGANA-URIAS CPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2016
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2865 SIENA HEIGHTS DR STE 120
HENDERSON NV
89052-4168
US

IV. Provider business mailing address

PO BOX 400670
LAS VEGAS NV
89140-0670
US

V. Phone/Fax

Practice location:
  • Phone: 702-940-8007
  • Fax: 702-832-1940
Mailing address:
  • Phone: 702-940-8007
  • Fax: 702-832-1940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: