Provider Demographics
NPI:1902611650
Name:TOLENTINO, NICOLLETTE JOY MANABAT
Entity type:Individual
Prefix:
First Name:NICOLLETTE JOY
Middle Name:MANABAT
Last Name:TOLENTINO
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 1:9864 SUNFLOWER HILL ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89178-3827
Mailing Address - Country:US
Mailing Address - Phone:702-523-8597
Mailing Address - Fax:
Practice Address - Street 1:9864 SUNFLOWER HILL ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89178-3827
Practice Address - Country:US
Practice Address - Phone:702-523-8597
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician