Healthcare Provider Details

I. General information

NPI: 1285148890
Provider Name (Legal Business Name): AMANDA DEVILLEZ PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2017
Last Update Date: 03/24/2025
Certification Date: 03/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7150 POLLOCK DR
LAS VEGAS NV
89119-9012
US

IV. Provider business mailing address

304 S JONES BLVD UNIT 2883
LAS VEGAS NV
89107-2623
US

V. Phone/Fax

Practice location:
  • Phone: 702-486-6517
  • Fax:
Mailing address:
  • Phone: 702-483-1599
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License NumberPY0826
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY0826
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: