MEDICARE: MRS. PAMELA AVANZINO LMFT

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	106H00000X	Marriage & Family Therapist	4913	NV

General Provider Information

NPI Number	:	1790439552
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PAMELA AVANZINO LMFT

Provider Business Mailing Address
First Line	:	180 W HUFFAKER LN
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89511-2346
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	180 W HUFFAKER LN
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89511-2346
Country	:	US
Telephone Number	:	775-433-8768
Fax Number	:

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

Provider Enumeration Date	:	02/09/2022
Last Update Date	:	03/28/2025

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