Provider Demographics
NPI:1154136216
Name:MAURICIO, SHALOM ARELLANO (RN)
Entity type:Individual
Prefix:MRS
First Name:SHALOM
Middle Name:ARELLANO
Last Name:MAURICIO
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 GALLETTI WAY UNIT 5
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-5560
Mailing Address - Country:US
Mailing Address - Phone:775-688-2077
Mailing Address - Fax:775-688-0506
Practice Address - Street 1:480 GALLETTI WAY UNIT 5
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-5560
Practice Address - Country:US
Practice Address - Phone:775-688-2001
Practice Address - Fax:775-688-0506
Is Sole Proprietor?:No
Enumeration Date:2025-02-07
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV860394163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult