Juventino Vazquez, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

83536 Issued in TX

Practice address

2629 E Yandell Dr Ste a
El Paso, TX 79903-3724

Phone

(915) 233-7145

NPI assigned

Mar 1, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Full Life Psychology PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • El Paso, TX
  • NPI 1669068284
  NPD

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

{
    "created_epoch": "1709251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709251200000",
    "number": "1972360451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5204 ANCHORAGE AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799243345",
            "telephone_number": "915-731-9822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2629 E YANDELL DR STE A",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799033724",
            "telephone_number": "915-233-7145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ",
        "first_name": "JUVENTINO",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-01",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "83536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edna Lizbeth Vazquez
• Eduardo Genaro Vazquez, M.D.
• Gerardo Vazquez, M.D.
• Jefferey Ruy Vazquez, D.P.M.
• Jorge Adan Vazquez, APRN-CNP
• Karina Vazquez
• Lilia A Vazquez, PT, DPT
• Lluvia Jaqueline Vazquez
• Marco Alejandro Vazquez
• Marylu Vazquez, M.S., CCC-SLP

• Professional Counselor in El Paso, TX
• Providers in El Paso, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.