Basic Information
Provider Information
NPI: 1811400823
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LOZANO
FirstName: ARELYN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1785 E SAHARA AVE STE 160
Address2:  
City: LAS VEGAS
State: NV
PostalCode: 891043759
CountryCode: US
TelephoneNumber: 7252528342
FaxNumber:  
Practice Location
Address1: 1785 E SAHARA AVE STE 160
Address2:  
City: LAS VEGAS
State: NV
PostalCode: 891043759
CountryCode: US
TelephoneNumber: 7022528342
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/13/2017
LastUpdateDate: 03/18/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/18/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225400000X  N Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner 
101YA0400X  Y Behavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)

No ID Information.


Home