Active NPI
Alexis Mutisya, BEHAVIOR TECHNICIAN
- Behavior Technician
- Reno, NV
National Provider Identifier
1043664253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-15-03062
- Practice address
- 2440 Vassar St
Ste.3
Reno, NV 89502-3453 - Phone
- (775) 448-6533
- Fax
- (775) 787-2751
- NPI assigned
- Apr 14, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | RBT-15-03062 | NV | |
| Behavior Technician | 106S00000X | RBT-15-03062 | NV | Primary |
Addresses
Primary practice location
2440 Vassar St
Ste.3
Reno, NV 89502-3453
Mailing address
2440 Vassar St
Ste.3
Reno, NV 89502-3453
Phone (775) 448-6533
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 |
|---|---|---|---|
| RBT-15-03062 | NV | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1460592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608595200000",
"number": "1043664253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2440 VASSAR ST",
"address_2": "STE.3",
"city": "RENO",
"state": "NV",
"postal_code": "895023453",
"telephone_number": "775-448-6533",
"fax_number": "775-787-2751"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2440 VASSAR ST",
"address_2": "STE.3",
"city": "RENO",
"state": "NV",
"postal_code": "895023453",
"telephone_number": "775-448-6533",
"fax_number": "775-787-2751"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUTISYA",
"first_name": "ALEXIS",
"credential": "BEHAVIOR TECHNICIAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-14",
"last_updated": "2020-12-22",
"certification_date": "2020-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NV",
"license": "RBT-15-03062",
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NV",
"license": "RBT-15-03062",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reno, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.