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General NPI Number Information
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NPI Number | 1023216884
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Entity Type | Organization
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Legal Business Name | DR YOLANDA A TREVINO LLC
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Dates
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Enumeration Date | 07/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2580 MONTESSOURI STREET SUITE 101A
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City | LAS VEGAS
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State | NV
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Zip | 89117-3065
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Country | US
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Telephone | 702-932-0146
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Fax | 702-256-2295
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Provider Business Mailing Address
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Address Line | 2580 MONTESSOURI STREET SUITE 101A
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City | LAS VEGAS
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State | NV
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Zip | 89117-3065
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Country | US
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Telephone | 702-932-0146
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Fax | 702-256-2295
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Authorized Official
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Title or Position | OWNER
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Name | DR. YOLANDA A TREVINO
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Credential | PHD
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Telephone | 702-932-0146
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 0936
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License Number State | NV
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