Provider Demographics
NPI:1073046181
Name:YAZ, SAUL
Entity Type:Individual
Prefix:
First Name:SAUL
Middle Name:
Last Name:YAZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4560 S EASTERN AVE STE 13
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-6182
Mailing Address - Country:US
Mailing Address - Phone:702-401-0811
Mailing Address - Fax:
Practice Address - Street 1:4560 S EASTERN AVE STE 13
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-6182
Practice Address - Country:US
Practice Address - Phone:702-401-0811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-05
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVIC-10931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical