Active NPI
Jonathan Page, PH.D.
- Psychologist
- Las Vegas, NV
National Provider Identifier
1306222187
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1166
- Practice address
- 732 S 6TH St Ste N
Las Vegas, NV 89101-6948 - Phone
- (510) 738-4078
- NPI assigned
- Aug 4, 2015
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 1166 | NV | Primary |
| Psychologist | 103T00000X | PSY29526 | CA |
Addresses
Primary practice location
732 S 6TH St Ste N
Las Vegas, NV 89101-6948
Mailing address
675 S Green Valley Pkwy # 1310
Henderson, NV 89052-0404
Phone (510) 738-4078
Other practice location 1
1820 E Warm Springs Rd Ste 140
Las Vegas, NV 89119-4593
Phone (702) 779-3956
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Nov 8, 2018 through Nov 8, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY29526 | CA | MD | Psychologist |
| 29526 | CA | MD | Pharmacist |
| 1166 | NV | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blue ABA Indiana LLC | Past | Accepting new patients | |
| A Step Forward | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Concord, CA
- NPI 1922203165
-
- Community/Behavioral Health Agency
- Indianapolis, IN
- NPI 1346972882
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438646400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1769385600000",
"number": "1306222187",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "675 S GREEN VALLEY PKWY # 1310",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890520404",
"telephone_number": "510-738-4078"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "732 S 6TH ST STE N",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891016948",
"telephone_number": "510-738-4078"
}
],
"practiceLocations": [
{
"address_1": "1820 E Warm Springs Rd Ste 140",
"address_purpose": "LOCATION",
"city": "Las Vegas",
"state": "NV",
"postal_code": "891194593",
"country_code": "US",
"telephone_number": "702-779-3956",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PAGE",
"first_name": "JONATHAN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-08-04",
"last_updated": "2026-01-26",
"certification_date": "2026-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NV",
"license": "1166",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY29526",
"primary": false
}
],
"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 Jan 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.