Provider Demographics
NPI:1841656071
Name:OBREGON-ALVAREZ, DIANA
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:OBREGON-ALVAREZ
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 1:7455 ARROYO CROSSING PKWY STE 220
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-4088
Mailing Address - Country:US
Mailing Address - Phone:321-443-9191
Mailing Address - Fax:702-483-6410
Practice Address - Street 1:7455 ARROYO CROSSING PKWY STE 220
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113
Practice Address - Country:US
Practice Address - Phone:321-443-9191
Practice Address - Fax:702-483-6410
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-04
Last Update Date:2018-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRBT-16-17319106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician