Individual provider Active NPI

Jaylin Cabagua, COTA/L

  • Occupational Therapy Assistant
  • Las Vegas, NV
National Provider Identifier
1164302774
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA-3001 Issued in NV
Practice address
9480 S Eastern Ave Ste 273
Las Vegas, NV 89123-8000
Phone
(702) 463-5460
NPI assigned
Sep 4, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA-3001 NV Primary

Addresses

Primary practice location

9480 S Eastern Ave Ste 273
Las Vegas, NV 89123-8000

Mailing address

4000 Madrone Dr
North Las Vegas, NV 89031-0162
Phone (702) 809-8328

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

LicenseStateTypeSpecialty
OTA-3001NVMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1756944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1164302774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 MADRONE DR",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890310162",
            "telephone_number": "702-809-8328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9480 S EASTERN AVE STE 273",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891238000",
            "telephone_number": "702-463-5460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABAGUA",
        "first_name": "JAYLIN",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-04",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NV",
            "license": "OTA-3001",
            "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 Sep 4, 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.