Provider Demographics
NPI:1285048355
Name:DINIO, JESUSA
Entity type:Individual
Prefix:
First Name:JESUSA
Middle Name:
Last Name:DINIO
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 1:1711 ANGEL FALLS ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89142-1229
Mailing Address - Country:US
Mailing Address - Phone:702-689-0607
Mailing Address - Fax:
Practice Address - Street 1:1711 ANGEL FALLS ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89142-1229
Practice Address - Country:US
Practice Address - Phone:702-689-0607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-17
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner