Provider Demographics
NPI:1841082161
Name:ARMENTA, VICTORIA KIMBERLY
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:KIMBERLY
Last Name:ARMENTA
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 1:6257 KESTER AVE APT 5
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91411-2143
Mailing Address - Country:US
Mailing Address - Phone:702-443-3628
Mailing Address - Fax:
Practice Address - Street 1:6230 S DECATUR BLVD STE 140
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-4368
Practice Address - Country:US
Practice Address - Phone:702-443-3628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-21
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Single Specialty