Jacqueline Defiesta, MT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

9649 Issued in NV

Practice address

5578 Longley LN
Reno, NV 89511-1825

Phone

(775) 284-8650

Fax

(775) 284-8654

NPI assigned

Mar 21, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jacqueline Lear Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Medical Technician

State licenses

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

{
    "created_epoch": "1679356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1437851458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1464 GRANARY PARK AVE",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894363754",
            "telephone_number": "775-722-1903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5578 LONGLEY LN",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895111825",
            "telephone_number": "775-284-8650",
            "fax_number": "775-284-8654"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2385 E Prater Way Ste 204",
            "address_purpose": "LOCATION",
            "city": "Sparks",
            "state": "NV",
            "postal_code": "894349688",
            "country_code": "US",
            "telephone_number": "775-284-8650",
            "fax_number": "775-870-1471",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEFIESTA",
        "first_name": "JACQUELINE",
        "credential": "MT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-21",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NV",
            "license": "9649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "LEAR",
            "credential": "MT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Erika Dedavilla Paredes
• Kathryn Dedonis
• Sara H Deen, D.D.S.
• Jeanette Irene Deering, DPT
• Lydia Catherine Deering, CCC-SLP
• Alison Michele Defilippi, DMD
• Rochelle Defluiter
• Ileana Cornelia Deftu, MD
• Tanner Dominick Degiovanni, PHARMD
• Stefanie Degrande

• Massage Therapist in Reno, NV
• Providers in Reno, NV by specialty
• Massage Therapist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2023; 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.