Provider Demographics
NPI:1740960988
Name:ECKLAND, DINA (PMHNP)
Entity type:Individual
Prefix:
First Name:DINA
Middle Name:
Last Name:ECKLAND
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10792 ROCKVALE FALLS AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89166-1247
Mailing Address - Country:US
Mailing Address - Phone:702-964-9292
Mailing Address - Fax:
Practice Address - Street 1:2029 CENTURY PARK EAST
Practice Address - Street 2:SUITE 400, OFFICE #422
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90067
Practice Address - Country:US
Practice Address - Phone:415-671-2165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-21
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95026986363LP0808X
NV865371363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health