Healthcare Provider Details
I. General information
NPI: 1144960246
Provider Name (Legal Business Name): YORDANOS ARAYA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/29/2022
Last Update Date: 03/29/2022
Certification Date: 03/29/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4850 W FLAMINGO RD STE 25A
LAS VEGAS NV
89103-3707
US
IV. Provider business mailing address
4361 ALEXIS DR
LAS VEGAS NV
89103-7411
US
V. Phone/Fax
- Phone: 702-871-9917
- Fax:
- Phone: 702-771-9068
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3747P1801X |
| Taxonomy | Personal Care Attendant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: