Provider Demographics
NPI:1013546902
Name:DE LA ROSA GARCIA, RUBIEL
Entity type:Individual
Prefix:
First Name:RUBIEL
Middle Name:
Last Name:DE LA ROSA GARCIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7501 WANDERCLOUD LN
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89145-5128
Mailing Address - Country:US
Mailing Address - Phone:725-577-0095
Mailing Address - Fax:
Practice Address - Street 1:1601 E FLAMINGO RD STE 18
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5244
Practice Address - Country:US
Practice Address - Phone:702-207-0842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-03
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
376J00000X, 106S00000X, 372500000X, 372600000X, 3747A0650X, 3747P1801X
NV890022163WG0000X, 163WH0200X, 163WN0800X, 163WP0808X
NV101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No376J00000XNursing Service Related ProvidersHomemaker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WN0800XNursing Service ProvidersRegistered NurseNeuroscience
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant