Provider Demographics
NPI:1760782734
Name:GUEVARA, LUIS F (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:F
Last Name:GUEVARA
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7351 W CHARLESTON BLVD STE 140
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-1572
Mailing Address - Country:US
Mailing Address - Phone:702-360-4836
Mailing Address - Fax:702-946-0866
Practice Address - Street 1:7351 W CHARLESTON BLVD STE 140
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-1572
Practice Address - Country:US
Practice Address - Phone:702-360-4836
Practice Address - Fax:702-946-0866
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-25
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPY0510103T00000X
CAPSY 17964103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist