Yudaimy Mesa Granados

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT3929 Issued in NV

Practice address

10585 Medicine Bow St
Las Vegas, NV 89183-4906

Phone

(702) 665-1519

NPI assigned

Oct 2, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Bright Path ABA LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Las Vegas, NV
  • NPI 1962386524
  NPD Authorized official

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

{
    "created_epoch": "1696204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1629858253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10585 MEDICINE BOW ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891834906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10585 MEDICINE BOW ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891834906",
            "telephone_number": "702-665-1519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESA GRANADOS",
        "first_name": "YUDAIMY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-02",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NV",
            "license": "RBT3929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick Mertz
• Sean Davyd Merwin
• Alexis Anne Merz
• Courtney Lynn Merz
• Ana Maria Mesa de Lara
• Benjamin Mesa Hidalgo
• Carlos Mesa Hidalgo
• Adela Mesa Lopez
• Jocelyn Mesa Lopez
• Mesa Pharmacy Inc

• Behavior Technician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Behavior Technician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.