Provider Demographics
NPI:1922432012
Name:CARRIZALES, YESENIA ARIEL (LSW)
Entity Type:Individual
Prefix:
First Name:YESENIA
Middle Name:ARIEL
Last Name:CARRIZALES
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:YESENIA
Other - Middle Name:ARIEL
Other - Last Name:CARRIZALES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LSW
Mailing Address - Street 1:3700 SAFE HARBOR WAY
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89512
Mailing Address - Country:US
Mailing Address - Phone:775-787-9411
Mailing Address - Fax:
Practice Address - Street 1:3700 SAFE HARBOR WAY
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89512-1137
Practice Address - Country:US
Practice Address - Phone:775-787-9411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-26
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)