Individual provider Active NPI

Yosbany Sanjudo

  • Behavior Technician
  • Las Vegas, NV
National Provider Identifier
1366944779
Registry record updated Jan 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
800 N Rainbow Blvd Ste 174
Las Vegas, NV 89107-1189
Phone
(702) 633-6072
NPI assigned
Mar 1, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

800 N Rainbow Blvd Ste 174
Las Vegas, NV 89107-1189

Mailing address

800 N Rainbow Blvd Ste 174
Las Vegas, NV 89107-1189
Phone (702) 633-6072

Other practice location 1

2575 S Cimarron Rd
Las Vegas, NV 89117-7653
Phone (702) 871-0002

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": "1519862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609718400000",
    "number": "1366944779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N RAINBOW BLVD STE 174",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891071189",
            "telephone_number": "702-633-6072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N RAINBOW BLVD STE 174",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891071189",
            "telephone_number": "702-633-6072"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2575 S Cimarron Rd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891177653",
            "country_code": "US",
            "telephone_number": "702-871-0002",
            "fax_number": "702-871-0201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANJUDO",
        "first_name": "YOSBANY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-01",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_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 Jan 4, 2021; 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.