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NPI Code Detail

MEDICARE: CRESENCIA D. VILLADELGADO

MEDICARE: CRESENCIA D. VILLADELGADO
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
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1477109288
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRESENCIA D. VILLADELGADO
Provider Business Mailing Address
First Line : 4775 S DURANGO DR STE 101
Second Line :
City : LAS VEGAS
State : NV
Zip : 89147-8157
Country : US
Telephone Number : 702-802-3585
Fax Number :
Provider Business Practice Location Address
First Line : 4775 S DURANGO DR STE 101
Second Line :
City : LAS VEGAS
State : NV
Zip : 89147-8157
Country : US
Telephone Number : 702-802-3585
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2019
Last Update Date : 08/16/2019

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Directions to “ CRESENCIA D. VILLADELGADO ” Practice Location

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