Provider Demographics
NPI:1598310971
Name:VILLASENOR, RACHELL MARIE
Entity Type:Individual
Prefix:
First Name:RACHELL
Middle Name:MARIE
Last Name:VILLASENOR
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 1:1963 E PRATER WAY # 101
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89434-8938
Mailing Address - Country:US
Mailing Address - Phone:702-845-3394
Mailing Address - Fax:
Practice Address - Street 1:1580 SUTRO ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89512-2440
Practice Address - Country:US
Practice Address - Phone:702-845-3394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-02
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide