Provider Demographics
NPI:1568266856
Name:CARREON, VICTOR HUGO JR
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:HUGO
Last Name:CARREON
Suffix:JR
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 W D ST
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-6159
Mailing Address - Country:US
Mailing Address - Phone:402-705-9570
Mailing Address - Fax:
Practice Address - Street 1:206 W D ST
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-6159
Practice Address - Country:US
Practice Address - Phone:402-705-9570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE12152508106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician