Active NPI
Iddolina Jailene Villarreal
- Behavior Technician
- Las Vegas, NV
National Provider Identifier
1730976028
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-25-415833
- Practice address
- 6325 S Jones Blvd Ste 400
Las Vegas, NV 89118-3332 - Phone
- (702) 618-9120
- NPI assigned
- Apr 22, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-25-415833 | NV | Primary |
Addresses
Primary practice location
6325 S Jones Blvd Ste 400
Las Vegas, NV 89118-3332
Mailing address
6255 W Tropicana Ave Apt 251
Las Vegas, NV 89103-4647
Phone (702) 416-6589
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
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-25-415833 | NV | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Proud Moments ABA of Nevada LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Behavior Analyst
- Henderson, NV
- NPI 1043780695
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1745280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1745280000000",
"number": "1730976028",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6255 W TROPICANA AVE APT 251",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891034647",
"telephone_number": "702-416-6589"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6325 S JONES BLVD STE 400",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891183332",
"telephone_number": "702-618-9120"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VILLARREAL",
"first_name": "IDDOLINA",
"middle_name": "JAILENE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-04-22",
"last_updated": "2025-04-22",
"certification_date": "2025-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NV",
"license": "RBT-25-415833",
"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 Apr 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.