Active NPI
Amy Favero Guevara, PSY.D.
- Psychologist
- Las Vegas, NV
National Provider Identifier
1386724813
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PY0511
- Practice address
- 2881 Business Park CT Ste 150
Las Vegas, NV 89128-9020 - Phone
- (702) 508-2112
- Fax
- (702) 965-4587
- NPI assigned
- Oct 17, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PY0511 | NV | Primary |
Addresses
Primary practice location
2881 Business Park CT Ste 150
Las Vegas, NV 89128-9020
Mailing address
2881 Business Park CT Ste 150
Las Vegas, NV 89128-9020
Phone (702) 508-2112
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100510273 | Medicaid | NV |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 30, 2024 through Jan 30, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY0511 | NV | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535587200000",
"number": "1386724813",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2881 BUSINESS PARK CT STE 150",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891289020",
"telephone_number": "702-508-2112",
"fax_number": "702-965-4587"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2881 BUSINESS PARK CT STE 150",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891289020",
"telephone_number": "702-508-2112",
"fax_number": "702-965-4587"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUEVARA",
"first_name": "AMY",
"middle_name": "FAVERO",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-17",
"last_updated": "2018-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NV",
"license": "PY0511",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100510273",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.