| Abide Health Medical A Professional Corporation | |
|
6847 W Charleston Blvd Ste B Las Vegas NV 89117-1648 | |
| (760) 803-2005 | |
| (725) 205-1690 |
| Full Name | Abide Health Medical A Professional Corporation |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 6847 W Charleston Blvd Ste B, Las Vegas, Nevada |
| Authorized Official Name and Position | Robert Cruz (PRESIDENT) |
| Authorized Official Contact | 6198627470 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Abide Health Medical A Professional Corporation 6847 W Charleston Blvd Ste B Las Vegas NV 89117-1648 Ph: () - | Abide Health Medical A Professional Corporation 6847 W Charleston Blvd Ste B Las Vegas NV 89117-1648 Ph: (760) 803-2005 |
| NPI Number | 1447034871 |
|---|---|
| Provider Enumeration Date | 08/24/2023 |
| Last Update Date | 01/23/2024 |
| Certification Date | 01/23/2024 |
| Medicare PECOS PAC ID | 3971950320 |
|---|---|
| Medicare Enrollment ID | O20231107002982 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447034871 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | John P Valles |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972545994 PECOS PAC ID: 8820060163 Enrollment ID: I20040809000354 |
| Provider Name | Lydia B Estanislao |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1154375798 PECOS PAC ID: 4385696178 Enrollment ID: I20050221000532 |
| Provider Name | Rodrigo L Farrales |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235379678 PECOS PAC ID: 6305985805 Enrollment ID: I20120918000397 |
| Provider Name | Grace Marie Samson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811650849 PECOS PAC ID: 5597130195 Enrollment ID: I20230413000746 |
| Provider Name | Maria Mondonedo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356052765 PECOS PAC ID: 8628423738 Enrollment ID: I20231010001937 |
| Provider Name | Ana W Pacis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194323121 PECOS PAC ID: 6305239096 Enrollment ID: I20231115003984 |
| Provider Name | Mark Z Quim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780456350 PECOS PAC ID: 2860844461 Enrollment ID: I20240119000170 |
| Provider Name | Razel Joy R Ortigas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073227948 PECOS PAC ID: 2961845920 Enrollment ID: I20240206003796 |
| Provider Name | Edelpaulette Jane Tumbali Pugh |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1902383334 PECOS PAC ID: 9537509542 Enrollment ID: I20240620003695 |
| Provider Name | Marilou Marasigan Cabusao |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700514957 PECOS PAC ID: 1052789781 Enrollment ID: I20240709004022 |
| Provider Name | Kenneth Clarete |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154148914 PECOS PAC ID: 4688108640 Enrollment ID: I20241113002075 |
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