Healthcare Provider Details

I. General information

NPI: 1912860909
Provider Name (Legal Business Name): VALDEMAR VILLASENOR ALVAREZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2415 REYNOLDS AVE STE 101
NORTH LAS VEGAS NV
89030-7279
US

IV. Provider business mailing address

2415 REYNOLDS AVE STE 101
NORTH LAS VEGAS NV
89030-7279
US

V. Phone/Fax

Practice location:
  • Phone: 702-906-1999
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: