Provider Demographics
NPI:1326719030
Name:JUAREZ-CHICAS, CELIA
Entity Type:Individual
Prefix:
First Name:CELIA
Middle Name:
Last Name:JUAREZ-CHICAS
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 1:3312 W CHARLESTON BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-1829
Mailing Address - Country:US
Mailing Address - Phone:702-971-2300
Mailing Address - Fax:
Practice Address - Street 1:3312 W CHARLESTON BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-1829
Practice Address - Country:US
Practice Address - Phone:702-971-2300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-22
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator