MEDICARE: LETICIA CERVANTES

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	103K00000X	Behavior Analyst	LBA0862	NV

General Provider Information

NPI Number	:	1871101618
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LETICIA CERVANTES

Provider Business Mailing Address
First Line	:	3024 HAILEY CT
Second Line	:
City	:	ELKO
State	:	NV
Zip	:	89801-2477
Country	:	US
Telephone Number	:	775-388-4545
Fax Number	:

Provider Business Practice Location Address
First Line	:	1250 LAMOILLE HWY STE 103
Second Line	:
City	:	ELKO
State	:	NV
Zip	:	89801-4397
Country	:	US
Telephone Number	:	775-777-1292
Fax Number	:

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

Provider Enumeration Date	:	07/17/2020
Last Update Date	:	12/17/2025

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1518304609 — ERIN TERRY
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1508203696 — MONICA GONZALEZ
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Directions to “ LETICIA CERVANTES ” Practice Location

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