Provider Demographics
NPI:1255830220
Name:SENDON ZALDIVAR, IVONNE IV
Entity Type:Individual
Prefix:MS
First Name:IVONNE
Middle Name:
Last Name:SENDON ZALDIVAR
Suffix:IV
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 1:2740 HERITAGE CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-1403
Mailing Address - Country:US
Mailing Address - Phone:702-417-8195
Mailing Address - Fax:
Practice Address - Street 1:2740 HERITAGE CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-1403
Practice Address - Country:US
Practice Address - Phone:702-417-8195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-06
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician