Healthcare Provider Details

I. General information

NPI: 1063348837
Provider Name (Legal Business Name): JULIETTE TOSHIKO WEINTRAUB I
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7861 DARBY AVE
LAS VEGAS NV
89117-2518
US

IV. Provider business mailing address

7861 DARBY AVE
LAS VEGAS NV
89117-2518
US

V. Phone/Fax

Practice location:
  • Phone: 702-561-4814
  • Fax:
Mailing address:
  • Phone: 702-561-4814
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number900901
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: