Provider Demographics
NPI:1861286064
Name:CANTOR FUQUEN, JHOAN SEBASTIAN
Entity type:Individual
Prefix:
First Name:JHOAN
Middle Name:SEBASTIAN
Last Name:CANTOR FUQUEN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4055 SPENCER ST STE 222
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-5251
Mailing Address - Country:US
Mailing Address - Phone:702-330-6158
Mailing Address - Fax:
Practice Address - Street 1:4055 SPENCER ST STE 222
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5251
Practice Address - Country:US
Practice Address - Phone:702-330-6158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-04
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor