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General NPI Number Information
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NPI Number | 1306580667
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Entity Type | Individual
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Provider Name | JANISHA RYANN CRUZ
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Gender | Female
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Dates
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Enumeration Date | 04/22/2022
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 601 S RANCHO DR STE A10
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City | LAS VEGAS
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State | NV
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Zip | 89106-4898
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Country | US
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Telephone | 702-437-4673
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Fax | 702-438-4673
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Provider Business Mailing Address
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Address Line | 6720 SURFBIRD ST
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89084-2255
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Country | US
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Telephone | 725-259-2695
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 10201-M
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License Number State | NV
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