Healthcare Provider Details

I. General information

NPI: 1053896118
Provider Name (Legal Business Name): REBECCA ANGELI SABALVARO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2018
Last Update Date: 12/14/2025
Certification Date: 12/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10775 DOUBLE R BLVD
RENO NV
89521-8956
US

IV. Provider business mailing address

10775 DOUBLE R BLVD
RENO NV
89521-8956
US

V. Phone/Fax

Practice location:
  • Phone: 253-922-4027
  • Fax:
Mailing address:
  • Phone: 253-922-4027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number748564
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2025033869
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: