Doctor Name: | DR. ALFREDO M AMEZAGA |
NPI Number: | 1013182559 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHD |
License Number: | PY0327 |
Business Practice Address: | 18124 Wedge Pkwy Ste. 538 Reno, NV - 895118134 |
Business Phone Number: | 8004015593 |
Business Fax Number: | 8004015593 |
Mailing Address: | 18124 Wedge Pkwy, Ste. 538 RENO |
State: | NV |
Postal Code: | 895118134 |
Phone Number: | 8004015593 |
Fax Number: | 8004015593 |
NPI Enumeration Date: | 04/25/2008 |
NPI Last Update Date: | 07/17/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TR0400X |
License Number: | PY0327 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NV |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Rehabilitation |
Taxonomy Definition: |