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NPI Code Detail

MEDICARE: VANESSA B. BECERRA-BAUTISTA

MEDICARE: VANESSA B. BECERRA-BAUTISTA
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
1225400000XRehabilitation Practitioner
2101YM0800XMental Health CounselorCP5538NV

General Provider Information

NPI Number : 1720385222
Entity Type Code : Individual
Provider Name (Legal Business Name) : VANESSA B. BECERRA-BAUTISTA
Provider Business Mailing Address
First Line : 5485 DUNGAREE ST
Second Line :
City : LAS VEGAS
State : NV
Zip : 89118-2089
Country : US
Telephone Number : 702-883-0722
Fax Number :
Provider Business Practice Location Address
First Line : 9550 S EASTERN AVE STE 253
Second Line :
City : LAS VEGAS
State : NV
Zip : 89123-8042
Country : US
Telephone Number : 702-883-0722
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/17/2011
Last Update Date : 04/16/2024

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Directions to “ VANESSA B. BECERRA-BAUTISTA ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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