MEDICARE: DEVA M. DORRIS, PSYD, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist
2	103G00000X	Clinical Neuropsychologist

General Provider Information

NPI Number	:	1134072796
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEVA M. DORRIS, PSYD, PLLC

Provider Business Mailing Address
First Line	:	7616 POPPY SPRINGS AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-3234
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7616 POPPY SPRINGS AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-3234
Country	:	US
Telephone Number	:	814-572-7404
Fax Number	:

Authorized Official
Title or Position	:	PSYCHOLOGIST
Name	:	DR. DEVA DORRIS
Credential	:	PSYD
Telephone Number	:	814-572-7404

Provider Enumeration Date	:	02/16/2026
Last Update Date	:	02/16/2026

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