Provider Demographics
NPI:1407212640
Name:NORTHERN NEVADA PSYCHIATRY LLC
Entity Type:Organization
Organization Name:NORTHERN NEVADA PSYCHIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DWARAKANATH
Authorized Official - Middle Name:
Authorized Official - Last Name:VUPPALAPATI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:775-291-8889
Mailing Address - Street 1:PO BOX 1811
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89702-1811
Mailing Address - Country:US
Mailing Address - Phone:775-291-8889
Mailing Address - Fax:775-964-4814
Practice Address - Street 1:1080 NORTH MINNESOTA STREET
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89702
Practice Address - Country:US
Practice Address - Phone:775-291-8889
Practice Address - Fax:775-964-4814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-04
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV108042084P0800X, 2084P0802X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Single Specialty