Provider Demographics
NPI:1376267989
Name:DAVILA JIMENEZ, CLAUDIA (CSW INTERN)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:
Last Name:DAVILA JIMENEZ
Suffix:
Gender:F
Credentials:CSW INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5426 VEGAS DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89108-2403
Mailing Address - Country:US
Mailing Address - Phone:702-806-5268
Mailing Address - Fax:
Practice Address - Street 1:5426 VEGAS DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89108-2403
Practice Address - Country:US
Practice Address - Phone:702-806-5268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-27
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVIC-20421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical