Brandon Auguste Tabamo

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

5575 S Durango Dr Ste 102
Las Vegas, NV 89113-1834

Phone

(702) 209-3544

Fax

(725) 205-3800

NPI assigned

Jul 12, 2022

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

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

{
    "created_epoch": "1657584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1013641455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9718 MASPALOMAS ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891787512",
            "telephone_number": "702-580-6678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5575 S DURANGO DR STE 102",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891131834",
            "telephone_number": "702-209-3544",
            "fax_number": "725-205-3800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9718 Maspalomas St",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891787512",
            "country_code": "US",
            "telephone_number": "702-580-6678",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TABAMO",
        "first_name": "BRANDON",
        "middle_name": "AUGUSTE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-12",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Machaela Tabalno
• Melona Tabanao
• Elena Tabar
• Maria Estela Tabares Hernandez
• Jennys Brenda Tabares Rivero
• Nazarita Tabares

• Behavior Technician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Behavior Technician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; 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.