Provider Demographics
NPI:1841778941
Name:GOMEZ-DECHAPARRO, VIVIANA OFELIA
Entity Type:Individual
Prefix:
First Name:VIVIANA
Middle Name:OFELIA
Last Name:GOMEZ-DECHAPARRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VIVIANA
Other - Middle Name:OFELIE
Other - Last Name:GOMEZ MORALES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2330 PASEO DEL PRADO STE C307
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-0076
Mailing Address - Country:US
Mailing Address - Phone:725-600-7953
Mailing Address - Fax:702-664-6933
Practice Address - Street 1:2330 PASEO DEL PRADO STE C307
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-0076
Practice Address - Country:US
Practice Address - Phone:725-600-7953
Practice Address - Fax:702-664-6933
Is Sole Proprietor?:No
Enumeration Date:2018-07-31
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant