Individual provider Active NPI

Jacqueline Glaza

  • Behavior Analyst
  • Las Vegas, NV
National Provider Identifier
1679940050
Registry record updated Sep 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
RBT-15-02742 Issued in NV
Practice address
2700 E Sunset Rd
Suite 24
Las Vegas, NV 89120-3506
Phone
(702) 635-0885
NPI assigned
Sep 1, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X RBT-15-02742 NV Primary

Addresses

Primary practice location

2700 E Sunset Rd
Suite 24
Las Vegas, NV 89120-3506

Mailing address

5606 Cedar Ave
Las Vegas, NV 89110-3805
Phone (702) 249-2135

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
RBT-15-02742NVMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1441065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441065600000",
    "number": "1679940050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5606 CEDAR AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891103805",
            "telephone_number": "702-249-2135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 E SUNSET RD",
            "address_2": "SUITE 24",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891203506",
            "telephone_number": "702-635-0885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLAZA",
        "first_name": "JACQUELINE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-01",
        "last_updated": "2015-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NV",
            "license": "RBT-15-02742",
            "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 Sep 1, 2015; 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.