Unknown Individual – Adult Psychiatric/Mental Health Registered Nurse, NPI 1780310417

Unknown Individual is a healthcare provider. based in Las vegas, Nevada. specializing in Adult Psychiatric/Mental Health Registered Nurse. They hold a License No. 713406 (CA). The NPI Number for Unknown Individual is 1780310417

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1780310417
Phone
(714) 478-1501
Address
12364 LOGGETA WAY
Deactivation Date
13 September 2023
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 12364 LOGGETA WAY

    LAS VEGAS, NV 891413019

    Phone: (714) 478-1501

    Type: Mailing

  • 6900 N PECOS RD

    NORTH LAS VEGAS, NV 890864400

    Phone: (702) 241-5942

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 89141)

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Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1780310417.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Adult Psychiatric/Mental Health Registered Nurse. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Las Vegas, Nevada in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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