DR. JUDE NIBA (NPI# 1821586512) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821586512 |
| Entity Type | Individual |
| Full Name | DR. JUDE NIBA |
| Practice Address |
9082 Vintage Wine Ave Las Vegas NV 89148 |
| Mailing Address |
9082 Vintage Wine Ave Las Vegas NV 89148-4916 |
| Practice Telephone | 1702328045 |
| Mailing Telephone | 1702328045 |
| Enumeration Date | 2018-04-27 |
| Last Update Date | 2018-06-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TE1100X |
Psychologist Specialization: Exercise & Sports |
667 | NV | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ASSOCIATION FOR APPLIED SPORT PSYCHOLOGY | 667 | 01 |
| Street Address |
9082 VINTAGE WINE AVE |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89148 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790282002 | Community Youth Interalia | Psychologist | 9082 Vintage Wine Ave, Las Vegas, NV 89148-4916 | 2018-04-12 |
| 1871055947 | Seao Interalia | Non-emergency Medical Transport (VAN) | 9082 Vintage Wine Ave, Las Vegas, NV 89148-4916 | 2019-04-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881293777 | Miguel Angel Umpierre | Technician | 9889 Overlook Ridge Ave, Las Vegas, NV 89148 | 2020-10-21 |
| 1689280588 | Santos Nunez | Technician | 7950 Mcginnis Ave, Las Vegas, NV 89148 | 2020-09-17 |
| 1861007734 | Daniel D Forro | Occupational Therapist | 10164 Phelps Lake Ct, Las Vegas, NV 89148 | 2020-09-08 |
| 1568098309 | Moinca R Ponce | Dentist | 9450 West Russell Rd, Suite #103, Las Vegas, NV 89148 | 2020-03-12 |
| 1689214876 | Mama Dukes Healthcare Services LLC | Rehabilitation Counselor | 9908 Masterpeice Drive, Las Vegas, NV 89148 | 2020-01-15 |
| 1720621865 | Building Hope Nevada | Community/Behavioral Health | 8936 Spanish Ridge, Las Vegas, NV 89148 | 2019-10-22 |
| 1790343721 | Maretes Godinez | Case Manager/Care Coordinator | 6070 S Fort Apache Rd., Suite 110, Las Vegas, NV 89148 | 2019-06-04 |
| 1295393601 | United Medical Group Pllc | Pharmacist | 9205 W. Russell Road, Building 3, Ste 240, Las Vegas, NV 89148 | 2019-05-31 |
| 1609358886 | Jdr Dermatology Research, LLC. | Dermatology | 9080 W Post Rd Ste 100, Las Vegas, NV 89148 | 2018-09-04 |
| 1902393929 | Hogue Healing Health and Hope, Pllc Dba H3, Pllc | Social Worker | 9205 W. Russell Rd Ste 240 Bldg 3, Las Vegas, NV 89148 | 2018-04-16 |
| Find all providers in zip 89148 | ||||
| Taxonomy Code | 103TE1100X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Exercise & Sports |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790282002 | Community Youth Interalia | Psychologist | 9082 Vintage Wine Ave, Las Vegas, NV 89148-4916 | 2018-04-12 |
| 1972098366 | Jordan Janelle-yvonne Jones | Psychologist | 4794 S Eastern Ave, Las Vegas, NV 89119 | 2018-06-27 |
Please comment or provide details below to improve the information on DR. JUDE NIBA.
| 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.