Organization
PSYCHGENESIS MEDICAL, PLLC
Active
Other names
PsycGenesis Medical, PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
EVA MARIA RIVERA NP-C (OWNER)
(702) 849-3767
Entity
Organization
Contact information
Practice address
5695 OAK ST, LAS VEGAS, NV 89120-1936
(702) 849-3767
(702) 441-1652
Mailing address
5695 OAK ST, LAS VEGAS, NV 89120-1936
(702) 849-3767
(702) 441-1652
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
363L00000X
Nurse Practitioner
Primary
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/24/2023
Last updated
04/27/2026
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