Individual provider Active NPI

Jhoana Delena Fusco

  • Behavior Technician
  • North Las Vegas, NV
National Provider Identifier
1417596578
Registry record updated Jan 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT1021 Issued in NV
Practice address
3926 Broken Oak LN
North Las Vegas, NV 89032-0129
Phone
(941) 779-4472
NPI assigned
Jan 6, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2020

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 RBT1021 NV Primary

Addresses

Primary practice location

3926 Broken Oak LN
North Las Vegas, NV 89032-0129

Mailing address

2715 E Russell Rd
Las Vegas, NV 89120-2426
Phone (702) 848-1696

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
RBT1021NVMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1578268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578873600000",
    "number": "1417596578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2715 E RUSSELL RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891202426",
            "telephone_number": "702-848-1696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3926 BROKEN OAK LN",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890320129",
            "telephone_number": "941-779-4472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUSCO",
        "first_name": "JHOANA",
        "middle_name": "DELENA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-06",
        "last_updated": "2020-01-13",
        "certification_date": "2020-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Technician",
            "state": "NV",
            "license": "RBT1021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North 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 13, 2020; 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.