Provider Demographics
NPI:1629814173
Name:CERVANTES LLAMAS, JAREN
Entity type:Individual
Prefix:
First Name:JAREN
Middle Name:
Last Name:CERVANTES LLAMAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4005 MOORPARK CT APT L375
Mailing Address - Street 2:
Mailing Address - City:SUN VALLEY
Mailing Address - State:NV
Mailing Address - Zip Code:89433-8276
Mailing Address - Country:US
Mailing Address - Phone:775-399-9076
Mailing Address - Fax:
Practice Address - Street 1:4005 MOORPARK CT APT L375
Practice Address - Street 2:
Practice Address - City:SUN VALLEY
Practice Address - State:NV
Practice Address - Zip Code:89433-8276
Practice Address - Country:US
Practice Address - Phone:775-399-9076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-03
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant