institution
Johanna S. Fricke, M.d., Llc
Medical Specialty Clinic/Center in Las Vegas, Nevada
NPI 1790108264

Johanna S. Fricke, M.d., Llc is a Medical Specialty Clinic/Center based in Las Vegas, NV and is specialized in Medical Specialty. Johanna S. Fricke, M.d., Llc practices in Las Vegas, NV. The NPI Number for Johanna S. Fricke, M.d., Llc is 1790108264 and holds a License No. (Nevada).

The current practice location address for Johanna S. Fricke, M.d., Llc is 311 N Buffalo Dr, Las Vegas, NV and can be reached out via phone at 702-877-2520 and via fax at 702-877-2521. You can also correspond with Johanna S. Fricke, M.d., Llc through the mailing address at 1300 PREMIER CT, LAS VEGAS, NV - 89117-7134 (mailing address contact number: 702-804-9065).

Location: 311 N Buffalo Dr, Las Vegas, NV, 89117-7134
institution
Provider Profile Details
NPI Number
1790108264
Provider Name
Johanna S. Fricke, M.d., Llc
Credential
Provider Entity Type
Organization
Address
311 N Buffalo Dr, Las Vegas, NV, 89117-7134
Phone Number
702-877-2520
Fax Number
702-877-2521
Provider Enumeration Date
02/03/2014
Last Update Date
03/13/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
32876 01 NV MEDICARE ID-TYPE UNSPECIFIED/MEDICARE
002002223 05 NV
CS09750 01 NV STATE PHARMACY
003102223 01 NV MEDICARE ID-TYPE UNSPECIFIED/NV MEDICAID
institution
Provider Business Practice Location Address Details
Address
311 N Buffalo Dr
City
State
Zip
89145-0375
Phone Number
702-877-2520
Fax Number
702-877-2521
person
Provider Business Mailing Address Details
Address
1300 Premier Ct
City
State
Zip
89117-7134
Phone Number
702-804-9065
Fax Number
702-877-2521
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Pediatrics
Speciality
Developmental - Behavioral Pediatrics
Taxonomy
License No.
(Nevada)
Definition
A developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development.
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Developmental Disabilities
Taxonomy
License No.
(Nevada)
Definition
An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.).
person
Provider's Taxonomy Details 3
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adolescent and Children Mental Health
Taxonomy
License No.
(Nevada)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
person
Provider's Taxonomy Details 4
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Medical Specialty
Taxonomy
License No.
(Nevada)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
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