GUSTAVO CANCINO (NPI# 1124527551) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124527551 |
| Entity Type | Individual |
| Full Name | GUSTAVO CANCINO |
| Practice Address |
1640 Alta Dr Ste 4 Las Vegas NV 89106-4165 |
| Practice Telephone | 7024746450 |
| Practice Fax Number | 7024746463 |
| Mailing Telephone | 7024746450 |
| Mailing Fax Number | 7024746463 |
| Enumeration Date | 2018-02-12 |
| Last Update Date | 2018-02-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| Street Address |
1640 ALTA DR STE 4 |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89106-4165 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982808960 | Milagros Severin-ruiz | Counselor | 1640 Alta Dr Ste 4, Las Vegas, NV 89106-4165 | 2007-06-13 |
| 1689214355 | Stacy Lynn Stanley | Counselor | 1640 Alta Dr Ste 4, Las Vegas, NV 89106-4165 | 2020-01-10 |
| 1265074439 | Veronica Alvarez | Counselor | 1640 Alta Dr Ste 4, Las Vegas, NV 89106-4165 | 2019-10-09 |
| 1619528320 | Sybria Davis | Specialist | 1640 Alta Dr Ste 4, Las Vegas, NV 89106-4165 | 2019-09-24 |
| 1356902688 | Yazmin Valdez Martinez | Counselor | 1640 Alta Dr Ste 4, Las Vegas, NV 89106-4165 | 2019-06-26 |
| 1467013789 | Christa Clayton | Counselor | 1640 Alta Dr Ste 4, Las Vegas, NV 89106-4165 | 2019-06-26 |
| 1003473422 | Rachel Mabuta Williams | Social Worker | 1640 Alta Dr Ste 4, Las Vegas, NV 89106-4165 | 2019-05-21 |
| 1659935591 | Jennifer R Gates | Marriage & Family Therapist | 1640 Alta Dr Ste 4, Las Vegas, NV 89106-4165 | 2019-04-25 |
| 1770042269 | Kimberly Jocelyn Rubalcava | Marriage & Family Therapist | 1640 Alta Dr Ste 4, Las Vegas, NV 89106-4165 | 2019-03-14 |
| 1992271076 | Samantha Blair Thurber | Counselor | 1640 Alta Dr Ste 4, Las Vegas, NV 89106-4165 | 2018-10-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417555772 | Graciela Miranda Cocorpio | Technician | 820 Rancho Ln Suite #40, Las Vegas, NV 89106 | 2020-10-09 |
| 1679101679 | A Better You Wellness Center | Counselor | 320 W Monroe Street, Las Vegas, NV 89106 | 2020-03-27 |
| 1730725177 | Mariah La'neese Jones | Rehabilitation Practitioner | 400 Shadow Lane Ste 106, Las Vegas, NV 89106 | 2019-11-20 |
| 1417592841 | Lourdes Rita Apumayta-paredes | Technician | 820 Rancho Lane, Suite #40, Las Vegas, NV 89106 | 2019-11-08 |
| 1902456551 | Marisela Pena | Technician | 820 Rancho Ln., 25, Las Vegas, NV 89106 | 2019-09-16 |
| 1992368724 | Amber Nicole Mahajan | Nurse Practitioner | 2020 Wellness Way, Suite 300, Las Vegas, NV 89106 | 2019-04-17 |
| 1568924215 | Arlandrea Tarvins | Behavioral Analyst | 1048 Miller Ave, Las Vegas, NV 89106 | 2019-04-02 |
| 1427510361 | Erik Pennell | Student in an Organized Health Care Education/Training Program | 1542 Pinto Ln, 2nd Floor, Las Vegas, NV 89106 | 2019-04-01 |
| 1245702729 | Bruce Mark Babb | Technician | 820 Rancho Lane Ste #40, Las Vegas, NV 89106 | 2018-12-21 |
| 1639649213 | Antonio Ruiz Pelfort | Technician | 1951 Stella Lake St Suite 36, Las Vegas, NV 89106 | 2018-11-27 |
| Find all providers in zip 89106 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518505536 | Ashley A Robinson | Peer Specialist | 2011 Pinto Lane Suite 200, Las Vegas, NV 89106-4007 | 2019-12-20 |
| 1972116929 | Renato Lucas Gerona Navarro-schlegel | Peer Specialist | 4221 Mcleod Dr, Las Vegas, NV 89121-5215 | 2020-08-28 |
| 1629638184 | Richard Gerard Brodmerkel | Peer Specialist | 1600 E Desert Inn Rd Ste 104, Las Vegas, NV 89169-2505 | 2019-06-17 |
| 1023674702 | Mark D Livingston | Peer Specialist | 2301 7th St Ste A, Las Vegas, NM 87701-4966 | 2019-05-17 |
| 1073013413 | Susana Lopez | Peer Specialist | 1640 Alta Dr, Las Vegas, NV 89106-4163 | 2018-02-12 |
| 1841790292 | Wendy Farko | Peer Specialist | 1640 Alta Dr Ste 4, Las Vegas, NV 89106-4165 | 2018-02-12 |
| 1184149460 | Braedan Singh | Peer Specialist | 323 N Maryland Pkwy, Las Vegas, NV 89101-3130 | 2017-08-08 |
| 1184149809 | Billy Joe West | Peer Specialist | 323 N Maryland Pkwy, Las Vegas, NV 89101-3130 | 2017-08-03 |
| 1407371123 | Katherine Ann Moore | Peer Specialist | 323 N Maryland Pkwy, Las Vegas, NV 89101-3130 | 2017-08-03 |
| 1437674140 | Christopher Foltz | Peer Specialist | 323 N Maryland Pkwy, Las Vegas, NV 89101-3130 | 2017-08-03 |
| Find all providers in LAS VEGAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.