=====================================================
General NPI Number Information
=====================================================
NPI Number | 1679428627
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JESSICA NAUMU
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/03/2026
-----------------------------------------------------
Last Update Date | 03/03/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1810 E SAHARA AVE STE 240
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89104-3707
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-886-0961
-----------------------------------------------------
Fax | 702-552-7421
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1810 E SAHARA AVE STE 240
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89104-3707
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-886-0961
-----------------------------------------------------
Fax | 702-552-7421
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | 13037-M
-----------------------------------------------------
License Number State | NV
-----------------------------------------------------