Bruna Jackson

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

12476944 Issued in FL

Practice address

9070 Kimberly Blvd Ste 19-20
Boca Raton, FL 33434-2855

Phone

(954) 988-0918

Fax

(954) 827-7625

NPI assigned

Feb 16, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Bruna Pevidor Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Minds in Motion ABA Therapy Center LLC

  • Behavior Analyst
  • Boca Raton, FL
  • NPI 1780215665
  NPD
• Progressive Behavioral Science

  • Behavior Analyst
  • Pompano Beach, FL
  • NPI 1851649297
  NPD (past)

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

{
    "created_epoch": "1518739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1841790813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9070 KIMBERLY BLVD STE 19-20",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334342855",
            "telephone_number": "954-988-0918",
            "fax_number": "954-827-7625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9070 KIMBERLY BLVD STE 19-20",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334342855",
            "telephone_number": "954-988-0918",
            "fax_number": "954-827-7625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "BRUNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-16",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "FL",
            "license": "02414985",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "12476944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRUNA",
            "last_name": "PEVIDOR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jabez Home Care LLC
• Jabez Home Care LLC
• Jack Pasula DC PA (Boca Pain Freedom)
• Deborah A Jackman, M.S. CCC-SLP
• Toby Jacknin, RN
• Erika Rae Jackson, DPT, PT
• Jahroy Winston Jackson
• Kathryn F Jackson, AUD
• Max Anthony Jackson
• Nadege Jackson, APRN

• Behavior Analyst in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.