Individual provider Active NPI

Jennifer Y Jimenez

  • Behavior Technician
  • Las Vegas, NV
National Provider Identifier
1962195461
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
3930 Howard Hughes Pkwy Ste 300
Las Vegas, NV 89169-0946
Phone
(702) 560-2192
NPI assigned
May 31, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

3930 Howard Hughes Pkwy Ste 300
Las Vegas, NV 89169-0946

Mailing address

2842 E Tonopah Ave
North Las Vegas, NV 89030-7392
Phone (702) 502-5612

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

NPI Registry JSON

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

{
    "created_epoch": "1685491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1962195461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2842 E TONOPAH AVE",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890307392",
            "telephone_number": "702-502-5612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3930 HOWARD HUGHES PKWY STE 300",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891690946",
            "telephone_number": "702-560-2192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "JENNIFER",
        "middle_name": "Y",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-31",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "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 May 31, 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.