Individual provider Active NPI

Ana L Vazquez

  • Clinical Social Worker
  • North Las Vegas, NV
National Provider Identifier
1003242553
Registry record updated Oct 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
12631-C Issued in NV
Practice address
4040 N Martin L King Blvd Ste a
North Las Vegas, NV 89032-3205
Phone
(702) 644-4673
NPI assigned
Sep 16, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 12631-C NV Primary

Addresses

Primary practice location

4040 N Martin L King Blvd Ste a
North Las Vegas, NV 89032-3205

Mailing address

4040 N Martin L King Blvd Ste a
North Las Vegas, NV 89032-3205
Phone (702) 644-4673

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251104002577 NV Practitioner - Clinical Social Worker 2961992490 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4040 N Martin Luther King Blvd
North Las Vegas, NV 89032

725 W Town and Country Rd
Orange, CA 92868-4703

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12631-CNVMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Hope Christian Health Center Corp Current Accepting new patients
Hope Christian Health Center Corp CurrentSince Oct 27, 2025 Accepting new patients

Locations

1581 N Main St
Las Vegas, NV 89101
Phone (702) 229-4732

4800 Alpine Pl
Ste 10
Las Vegas, NV 89107
Phone (702) 644-4673

4357 Corporate Center Dr
Ste 450
North Las Vegas, NV 89030
Phone (702) 644-4673

4040 N Martin L King Blvd
Ste A
North Las Vegas, NV 89032
Phone (702) 644-4673

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FFGHCA/Endpoint/FFGHCA

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1379289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1003242553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 N MARTIN L KING BLVD STE A",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890323205",
            "telephone_number": "702-644-4673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 N MARTIN L KING BLVD STE A",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890323205",
            "telephone_number": "702-644-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ",
        "first_name": "ANA",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-16",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "12631-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.