Healthcare Provider Details

I. General information

NPI: 1295546588
Provider Name (Legal Business Name): KIMBERLY FIGUEROA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2025
Last Update Date: 01/15/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2490 PASEO VERDE PARKWAY
HENDERSON NV
89074
US

IV. Provider business mailing address

3320 N. BRONCO ST.
LAS VEGAS NV
89108
US

V. Phone/Fax

Practice location:
  • Phone: 702-515-4009
  • Fax:
Mailing address:
  • Phone: 702-350-9955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOTA-3599
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: