Provider Demographics
NPI:1952100083
Name:CANALES, JOSE LUIS JR
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:LUIS
Last Name:CANALES
Suffix:JR
Gender:
Credentials:
Other - Prefix:
Other - First Name:JOSE
Other - Middle Name:LUIS
Other - Last Name:CANALES
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5504 SNORING CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89110-1759
Mailing Address - Country:US
Mailing Address - Phone:702-583-0565
Mailing Address - Fax:
Practice Address - Street 1:5504 SNORING CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89110-1759
Practice Address - Country:US
Practice Address - Phone:702-583-0565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No376J00000XNursing Service Related ProvidersHomemaker