Individual provider Active NPI

Jajuane Deshone Fisher II

  • Behavior Technician
  • Las Vegas, NV
National Provider Identifier
1093514622
Registry record updated Mar 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
700 Wardelle St Unit 223
Las Vegas, NV 89101-3613
Phone
(702) 985-3769
NPI assigned
Mar 7, 2025
Last updated
Mar 7, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior TechnicianGroup: 193400000X SINGLE SPECIALTY GROUP 106S00000X Primary

Addresses

Primary practice location

700 Wardelle St Unit 223
Las Vegas, NV 89101-3613

Mailing address

700 Wardelle St Unit 223
Las Vegas, NV 89101-3613
Phone (702) 985-3769

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

NPI Registry JSON

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

{
    "created_epoch": "1741305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741305600000",
    "number": "1093514622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 WARDELLE ST UNIT 223",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891013613",
            "telephone_number": "702-985-3769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 WARDELLE ST UNIT 223",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891013613",
            "telephone_number": "702-985-3769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "JAJUANE",
        "middle_name": "DESHONE",
        "name_suffix": "II",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-03-07",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "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 Mar 7, 2025; 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.