Healthcare Provider Details

I. General information

NPI: 1891457404
Provider Name (Legal Business Name): VICTORIA SAMBERG APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VICTORIA HALLAS

II. Dates (important events)

Enumeration Date: 10/11/2021
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5305 RENO CORPORATE DR
RENO NV
89511-2375
US

IV. Provider business mailing address

5305 RENO CORPORATE DR
RENO NV
89511-2375
US

V. Phone/Fax

Practice location:
  • Phone: 775-525-1095
  • Fax: 775-329-2550
Mailing address:
  • Phone: 775-525-1095
  • Fax: 775-329-2550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number95215904
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number324809
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number824309
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: