MEDICARE: DR. JOSETTE ANN IRIBARNE-LAZCANO PHD

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	103TC0700X	Clinical Psychologist	PY0921	NV

General Provider Information

NPI Number	:	1326348764
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSETTE ANN IRIBARNE-LAZCANO PHD

Provider Business Mailing Address
First Line	:	1140 NORTH FORK TRAIL
Second Line	:
City	:	MINDEN
State	:	NV
Zip	:	89423-0782
Country	:	US
Telephone Number	:	775-750-1272
Fax Number	:

Provider Business Practice Location Address
First Line	:	1650 LUCERNE ST STE 205
Second Line	:
City	:	MINDEN
State	:	NV
Zip	:	89423-4312
Country	:	US
Telephone Number	:	775-391-0354
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2010
Last Update Date	:	02/17/2023

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