Healthcare Provider Details

I. General information

NPI: 1265131379
Provider Name (Legal Business Name): WANDA LESLIE WEST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2023
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 E WARM SPRINGS RD STE 100
LAS VEGAS NV
89119-4345
US

IV. Provider business mailing address

6033 TORCIANO ST
NORTH LAS VEGAS NV
89081-6945
US

V. Phone/Fax

Practice location:
  • Phone: 702-486-6723
  • Fax:
Mailing address:
  • Phone: 951-733-6083
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: