Provider Demographics
NPI:1710435524
Name:CARTAYA AGUILAR, ERICK
Entity Type:Individual
Prefix:
First Name:ERICK
Middle Name:
Last Name:CARTAYA AGUILAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 N GREEN VALLEY PKWY STE 202
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-6171
Mailing Address - Country:US
Mailing Address - Phone:702-906-0027
Mailing Address - Fax:702-906-0160
Practice Address - Street 1:5495 S RAINBOW BLVD STE 202
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-1873
Practice Address - Country:US
Practice Address - Phone:702-906-0027
Practice Address - Fax:702-906-0160
Is Sole Proprietor?:No
Enumeration Date:2016-09-21
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
NV832363363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst