Provider Demographics
NPI:1285031500
Name:DELOSSANTOS, SENIDA
Entity Type:Individual
Prefix:
First Name:SENIDA
Middle Name:
Last Name:DELOSSANTOS
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 1:250 GLENMANOR DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-3727
Mailing Address - Country:US
Mailing Address - Phone:775-250-1811
Mailing Address - Fax:
Practice Address - Street 1:770 MILL ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1321
Practice Address - Country:US
Practice Address - Phone:775-636-7767
Practice Address - Fax:775-391-5998
Is Sole Proprietor?:No
Enumeration Date:2014-12-02
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0802564451103K00000X
NVMI1214106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst