Healthcare Provider Details

I. General information

NPI: 1467091710
Provider Name (Legal Business Name): SANDRA STELLA ROMERO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2020
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 MCCABE DR UNIT 19122
RENO NV
89511-4145
US

IV. Provider business mailing address

7711 SKY VISTA PKWY UNIT 5823
RENO NV
89506-2276
US

V. Phone/Fax

Practice location:
  • Phone: 775-391-0363
  • Fax:
Mailing address:
  • Phone: 609-457-1264
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-2845164
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: