Provider Demographics
NPI:1740855097
Name:PEBBLES PSYCHIATRY LLC
Entity type:Organization
Organization Name:PEBBLES PSYCHIATRY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NP/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:YVETTE
Authorized Official - Last Name:PEBBLES
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, APRN, PMHNP-BC
Authorized Official - Phone:775-418-5990
Mailing Address - Street 1:PO BOX 51630
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89435-1630
Mailing Address - Country:US
Mailing Address - Phone:775-418-5990
Mailing Address - Fax:775-418-5991
Practice Address - Street 1:515 COURT STREET
Practice Address - Street 2:LOWER LEVEL SUITE D
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89501
Practice Address - Country:US
Practice Address - Phone:775-418-5990
Practice Address - Fax:775-418-5991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-20
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty