Provider Demographics
NPI:1003353905
Name:CARRETO, VALERIA VIRGINIA
Entity Type:Individual
Prefix:
First Name:VALERIA
Middle Name:VIRGINIA
Last Name:CARRETO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110 LOS FELIZ ST UNIT 1043
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89156-8015
Mailing Address - Country:US
Mailing Address - Phone:702-908-9325
Mailing Address - Fax:
Practice Address - Street 1:5544 MYRON CIR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89142-1123
Practice Address - Country:US
Practice Address - Phone:505-814-9745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-30
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician