Healthcare Provider Details

I. General information

NPI: 1578313797
Provider Name (Legal Business Name): GENNA MARIE MASHINCHI PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2024
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2430 W HORIZON RIDGE PKWY
HENDERSON NV
89052-2729
US

IV. Provider business mailing address

2430 W HORIZON RIDGE PKWY
HENDERSON NV
89052-2729
US

V. Phone/Fax

Practice location:
  • Phone: 702-247-9994
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPY1305
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberPA151
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: