Provider Demographics
NPI:1336621606
Name:JAIME, CLAUDIA SOLEDAD
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:SOLEDAD
Last Name:JAIME
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 HARVEST DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89108-7775
Mailing Address - Country:US
Mailing Address - Phone:702-417-3039
Mailing Address - Fax:
Practice Address - Street 1:1901 HARVEST DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89108-7775
Practice Address - Country:US
Practice Address - Phone:702-417-3039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-04
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1403006413OtherDL