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NPI Code Detail

MEDICARE: IVANA BECERRA

MEDICARE:   IVANA  BECERRA
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 : 1790260784
Entity Type Code : Individual
Provider Name (Legal Business Name) : IVANA BECERRA
Provider Business Mailing Address
First Line : 6128 W SAHARA AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-3051
Country : US
Telephone Number : 702-598-2048
Fax Number :
Provider Business Practice Location Address
First Line : 6784 CASA LINDA DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89103-1020
Country : US
Telephone Number : 702-881-8980
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2018
Last Update Date : 09/26/2018

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Directions to “ IVANA BECERRA ” Practice Location

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