Healthcare Provider Details

I. General information

NPI: 1659287027
Provider Name (Legal Business Name): CECILIA VICTORIA BISHOP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1698 MEADOW WOOD LN
RENO NV
89502-6707
US

IV. Provider business mailing address

3279 RENO VISTA DR
RENO NV
89512-1127
US

V. Phone/Fax

Practice location:
  • Phone: 775-637-0030
  • Fax:
Mailing address:
  • Phone: 775-637-0030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number0807435861
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: