Antonio Barraza | Las Vegas, NV • PECOS Search

Antonio Barraza

Counselor

Behavioral Health & Social Service Providers

6171 W Charleston Blvd Bldg 7, Las Vegas, NV 89146-1126

(702) 486-6715 (702) 306-8661

PECOS Enrollment

Based on the most recent information from CMS, provider Antonio Barraza does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1710368287
Provider Type
Individual
Full Name
Barraza, Antonio
Gender
Male

Sole Proprietor
Yes
Enumeration Date
6/10/2015
Last Updated
5/31/2024

Contact Information

Practice Location

6171 W Charleston Blvd Bldg 7, Las Vegas, NV 89146-1126

Unlisted Fax

Mailing Location

6171 W Charleston Blvd # 7, Las Vegas, NV 89146-1126

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YM0800X Primary	Description Counselor Behavioral Health & Social Service Providers	License 10577-C Nevada