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NPI Code Detail

MEDICARE: JOHANA KATHERINE GARCIA VASCO

MEDICARE: JOHANA KATHERINE GARCIA VASCO
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 : 1972388064
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHANA KATHERINE GARCIA VASCO
Provider Business Mailing Address
First Line : 5323 ESTORNINO AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89108-4097
Country : US
Telephone Number : 702-485-7551
Fax Number :
Provider Business Practice Location Address
First Line : 625 N LAMB BLVD STE 130
Second Line :
City : LAS VEGAS
State : NV
Zip : 89110-6355
Country : US
Telephone Number : 702-331-0100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2023
Last Update Date : 08/28/2023

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