Provider Demographics
NPI:1780183129
Name:CAYABYAB, VIVIAN LAZATIN (APRN AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:VIVIAN
Middle Name:LAZATIN
Last Name:CAYABYAB
Suffix:
Gender:F
Credentials:APRN AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14001 SUMMIT SIERRA BLVD UNIT 1285
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-9330
Mailing Address - Country:US
Mailing Address - Phone:702-285-9779
Mailing Address - Fax:
Practice Address - Street 1:1600 MEDICAL PARKWAY
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:NV
Practice Address - Zip Code:89703
Practice Address - Country:US
Practice Address - Phone:775-445-8795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPRN002795163WC0200X, 363LA2200X, 363LG0600X, 363LA2100X
NVRN76135163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology