Active NPI
Gabriel Ian Mendoza
- Behavior Analyst
- Las Vegas, NV
National Provider Identifier
1013383280
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 193400000X
- Practice address
- 2700 E Sunset Rd
24
Las Vegas, NV 89120-3506 - Phone
- (702) 270-3219
- NPI assigned
- Aug 11, 2015
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 193400000X | NV | Primary |
Addresses
Primary practice location
2700 E Sunset Rd
24
Las Vegas, NV 89120-3506
Mailing address
2700 E Sunset Rd
24
Las Vegas, NV 89120-3506
Phone (702) 270-3219
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 193400000X | NV | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439251200000",
"number": "1013383280",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2700 E SUNSET RD",
"address_2": "24",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891203506",
"telephone_number": "702-270-3219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2700 E SUNSET RD",
"address_2": "24",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891203506",
"telephone_number": "702-270-3219"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENDOZA",
"first_name": "GABRIEL IAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-08-11",
"last_updated": "2015-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NV",
"license": "193400000X",
"primary": true
}
],
"identifiers": [],
"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 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.