Healthcare Provider Details

I. General information

NPI: 1699692251
Provider Name (Legal Business Name): YAHAIRA NATALI MAGANA-VIZCAINO CADC-I
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 DATE PALM DR
SPARKS NV
89441-0593
US

IV. Provider business mailing address

190 DATE PALM DR
SPARKS NV
89441-0593
US

V. Phone/Fax

Practice location:
  • Phone: 775-276-1671
  • Fax: 775-276-1671
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number08329-I
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: