Fuimaono, Deja Rachelle Ethel

Fuimaono, Deja Rachelle Ethel is an sole proprietor health care provider with primary practice located at 7836 W Sahara Ave , Las Vegas NV 89117-1944. She recently has 2 registered licenses in different health care specialties including Agencies / Foster Care Agency, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Fuimaono, Deja Rachelle Ethel can be contacted via phone (702) 499-4922.

Contact Information

Primary practice address
7836 W Sahara Ave Las Vegas NV 89117-1944
Phone: (702) 499-4922
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Agencies / Foster Care Agency 253J00000X
Behavioral Health & Social Service Providers / Clinical 1041C0700X 8661-C Nevada

Profile Details

NPI number 1497028682
LBN Legal business name Fuimaono, Deja Rachelle Ethel
Credentials LSW, MSW, LCSW
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 17th, 2012
Last updated Mar 22nd, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497028682 NPPES
Nevada MEDICAID 14927028682
Nevada MEDICAID 1497028682

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