Provider Demographics
NPI:1417780180
Name:VICTORIA, MARIA CLARIZZA
Entity type:Individual
Prefix:
First Name:MARIA CLARIZZA
Middle Name:
Last Name:VICTORIA
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 1:9742 MARCELLINE AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-5752
Mailing Address - Country:US
Mailing Address - Phone:702-582-3815
Mailing Address - Fax:
Practice Address - Street 1:9742 MARCELLINE AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-5752
Practice Address - Country:US
Practice Address - Phone:702-580-0890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-20
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion