Provider Demographics
NPI:1427266139
Name:ARTIGA, LISSETTE (CPC INTERN)
Entity type:Individual
Prefix:
First Name:LISSETTE
Middle Name:
Last Name:ARTIGA
Suffix:
Gender:F
Credentials:CPC INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3340 TOPAZ ST STE 170
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-3906
Mailing Address - Country:US
Mailing Address - Phone:702-268-7604
Mailing Address - Fax:702-442-8840
Practice Address - Street 1:3340 TOPAZ ST STE 170
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-3906
Practice Address - Country:US
Practice Address - Phone:702-268-7604
Practice Address - Fax:702-442-8840
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV00839I101YA0400X
NVCPCI5022101YP2500X
NVCI5022101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1821698556Medicaid