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General NPI Number Information
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NPI Number | 1326348764
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Entity Type | Individual
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Provider Name | JOSETTE ANN IRIBARNE-LAZCANO PHD
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Gender | Female
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Dates
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Enumeration Date | 11/02/2010
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Last Update Date | 02/17/2023
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Provider Practice Location Address
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Address Line | 1650 LUCERNE ST STE 205
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City | MINDEN
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State | NV
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Zip | 89423-4312
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Country | US
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Telephone | 775-391-0354
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Fax |
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Provider Business Mailing Address
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Address Line | 1140 NORTH FORK TRAIL
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City | MINDEN
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State | NV
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Zip | 89423-0782
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Country | US
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Telephone | 775-750-1272
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY0921
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License Number State | NV
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