Individual provider Active NPI

Jennifer A C Bonow, PHD, BCBA-D, LBA

  • Behavior Analyst
  • Sparks, NV
National Provider Identifier
1174887533
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
LBA0006 Issued in NV
Practice address
2435 Pyramid Way Ste B
Sparks, NV 89431-1865
Phone
(775) 657-8309
Fax
(775) 657-8359
NPI assigned
Jun 30, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X LBA0006 NV Primary

Addresses

Primary practice location

2435 Pyramid Way Ste B
Sparks, NV 89431-1865

Mailing address

2435 Pyramid Way Ste B
Sparks, NV 89431-1865
Phone (775) 657-8309

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LBA0006NVMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Sage Collective Learning Consultants Behavior Analyst Current Accepting new patients

Locations

7111 S Virginia St
Ste A6
Reno, NV 89511
Phone (775) 657-8309

2435 Pyramid Way
Ste B
Sparks, NV 89431
Phone (775) 432-2742

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1341014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1174887533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2435 PYRAMID WAY STE B",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894311865",
            "telephone_number": "775-657-8309",
            "fax_number": "775-657-8359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2435 PYRAMID WAY STE B",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894311865",
            "telephone_number": "775-657-8309",
            "fax_number": "775-657-8359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONOW",
        "first_name": "JENNIFER",
        "middle_name": "A C",
        "name_prefix": "Dr.",
        "credential": "PHD, BCBA-D, LBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-30",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NV",
            "license": "LBA0006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparks, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; 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.