Healthcare Provider Details

I. General information

NPI: 1174483044
Provider Name (Legal Business Name): CASSANDRA LARENTE DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2025
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6048 S DURANGO DR STE 100
LAS VEGAS NV
89113-1781
US

IV. Provider business mailing address

6048 S DURANGO DR STE 100
LAS VEGAS NV
89113-1781
US

V. Phone/Fax

Practice location:
  • Phone: 702-260-6238
  • Fax: 702-263-6530
Mailing address:
  • Phone: 702-260-6238
  • Fax: 702-260-6530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number6896
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: