Healthcare Provider Details

I. General information

NPI: 1992201354
Provider Name (Legal Business Name): PARRA PSYCHIATRY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2018
Last Update Date: 10/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6940 SIERRA CENTER PKWY
RENO NV
89511-2209
US

IV. Provider business mailing address

2268 EVANS CREEK TER
RENO NV
89519-7360
US

V. Phone/Fax

Practice location:
  • Phone: 775-393-2201
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number14433
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW PARRA
Title or Position: OWNER/SOLE PROPRIETOR
Credential:
Phone: 775-220-9819