Provider Demographics
NPI:1780276014
Name:VESPIA, NICHOLAS T
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:T
Last Name:VESPIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:NICHOLAS
Other - Middle Name:T
Other - Last Name:ALMEIDA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7912 COPPER CANYON RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-4102
Mailing Address - Country:US
Mailing Address - Phone:702-217-5347
Mailing Address - Fax:
Practice Address - Street 1:5940 S RAINBOW BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-2506
Practice Address - Country:US
Practice Address - Phone:925-264-1902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-08
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician