Healthcare Provider Details

I. General information

NPI: 1619849270
Provider Name (Legal Business Name): YAIMA NAVARRO GOMEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2025
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5081 E HACIENDA AVE
LAS VEGAS NV
89122-6940
US

IV. Provider business mailing address

5081 E HACIENDA AVE
LAS VEGAS NV
89122-6940
US

V. Phone/Fax

Practice location:
  • Phone: 702-339-5673
  • Fax: 702-933-9547
Mailing address:
  • Phone: 702-339-5673
  • Fax: 702-933-9547

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: