Provider Demographics
NPI:1083031876
Name:SUZANNE M ABERASTURI PHD.
Entity Type:Organization
Organization Name:SUZANNE M ABERASTURI PHD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / NEUROPSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:ABERASTURI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:775-200-1232
Mailing Address - Street 1:2450 VASSAR ST STE 3A
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-3454
Mailing Address - Country:US
Mailing Address - Phone:775-200-1232
Mailing Address - Fax:775-200-1232
Practice Address - Street 1:2450 VASSAR ST STE 3A
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-3454
Practice Address - Country:US
Practice Address - Phone:775-200-1232
Practice Address - Fax:775-200-1232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-18
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPY0547103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1649453911Medicaid
NV1649453911Medicaid