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NPI Code Detail

MEDICARE: DAHENNE CARBALLO

MEDICARE: DAHENNE CARBALLO
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
1372500000XChore Provider
2372600000XAdult Companion
33747A0650XAttendant Care Provider
43747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1952061640
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAHENNE CARBALLO
Provider Business Mailing Address
First Line : 3305 SPRING MOUNTAIN RD STE 61
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-8624
Country : US
Telephone Number : 702-485-4838
Fax Number :
Provider Business Practice Location Address
First Line : 3305 SPRING MOUNTAIN RD STE 61
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-8624
Country : US
Telephone Number : 702-485-4838
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2021
Last Update Date : 12/22/2021

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Directions to “ DAHENNE CARBALLO ” Practice Location

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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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