Healthcare Provider Details

I. General information

NPI: 1548284524
Provider Name (Legal Business Name): JASON SCOTT SCHWARTZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 E CHARLESTON BLVD SUITE 230
LAS VEGAS NV
89104-6659
US

IV. Provider business mailing address

4000 E CHARLESTON BLVD SUITE 230
LAS VEGAS NV
89104-6659
US

V. Phone/Fax

Practice location:
  • Phone: 702-968-5058
  • Fax: 702-968-5050
Mailing address:
  • Phone: 702-968-5058
  • Fax: 702-968-5050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number01747-S
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: