Provider Demographics
NPI:1790382471
Name:SANDOVAL ALVEAR, JULIANA
Entity type:Individual
Prefix:
First Name:JULIANA
Middle Name:
Last Name:SANDOVAL ALVEAR
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 1:5575 S DURANGO DR STE 102
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-1834
Mailing Address - Country:US
Mailing Address - Phone:702-329-0125
Mailing Address - Fax:
Practice Address - Street 1:5575 S DURANGO DR STE 102
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-1834
Practice Address - Country:US
Practice Address - Phone:702-329-0125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-06
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARBT-20-132502106S00000X
NV1-24-78622103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician