Healthcare Provider Details

I. General information

NPI: 1962398602
Provider Name (Legal Business Name): MIKAYLA SARGENTI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2025
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 KIETZKE LN # J212
RENO NV
89502-5033
US

IV. Provider business mailing address

2955 LAKESIDE DR UNIT 231
RENO NV
89509-4234
US

V. Phone/Fax

Practice location:
  • Phone: 775-348-9047
  • Fax:
Mailing address:
  • Phone: 775-525-4503
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: