Provider Demographics
NPI:1972053338
Name:YEPEZ, MASHARA (LMFT)
Entity Type:Individual
Prefix:
First Name:MASHARA
Middle Name:
Last Name:YEPEZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 50914
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89435-0914
Mailing Address - Country:US
Mailing Address - Phone:775-453-4604
Mailing Address - Fax:
Practice Address - Street 1:1030 HOLCOMB AVE
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-2427
Practice Address - Country:US
Practice Address - Phone:775-453-4604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2716106H00000X
NVMI0799106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist