Healthcare Provider Details

I. General information

NPI: 1851118988
Provider Name (Legal Business Name): ALONDRA ESCOBEDO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2024
Last Update Date: 09/20/2024
Certification Date: 09/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3441 W SAHARA AVE
LAS VEGAS NV
89102-6061
US

IV. Provider business mailing address

3441 W SAHARA AVE
LAS VEGAS NV
89102-6061
US

V. Phone/Fax

Practice location:
  • Phone: 702-445-7318
  • Fax:
Mailing address:
  • Phone: 702-445-7318
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number07813-I
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: