Healthcare Provider Details

I. General information

NPI: 1497770648
Provider Name (Legal Business Name): ADRIANE AMANA ALCALA MOSS PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1755 SULLIVAN LN
SPARKS NV
89431-2815
US

IV. Provider business mailing address

1935 G ST
SPARKS NV
89431-4334
US

V. Phone/Fax

Practice location:
  • Phone: 775-355-7734
  • Fax:
Mailing address:
  • Phone: 541-760-7958
  • Fax: 323-978-6678

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number862485
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: