Provider Demographics
NPI:1326766320
Name:DAMIAN JARAMILLO, KRISTY (LMSW, CSW-I)
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:
Last Name:DAMIAN JARAMILLO
Suffix:
Gender:F
Credentials:LMSW, CSW-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 GRAND CANYON BLVD APT 8
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-9306
Mailing Address - Country:US
Mailing Address - Phone:775-750-0344
Mailing Address - Fax:
Practice Address - Street 1:690 EDISON WAY
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-4100
Practice Address - Country:US
Practice Address - Phone:775-858-4571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-16
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10057-M104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker