Provider Demographics
NPI:1689485187
Name:BARAHONA-BARILLAS, JASMINE (CST)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:BARAHONA-BARILLAS
Suffix:
Gender:F
Credentials:CST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 97618
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89193-7618
Mailing Address - Country:US
Mailing Address - Phone:702-933-9393
Mailing Address - Fax:702-933-6789
Practice Address - Street 1:9499 W CHARLESTON BLVD STE 200
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-7147
Practice Address - Country:US
Practice Address - Phone:702-933-9393
Practice Address - Fax:702-933-6789
Is Sole Proprietor?:No
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV100278656246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist