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NPI Code Detail

MEDICARE: JD MEDICAL BEHAVIORAL HEALTH CORP

MEDICARE: JD MEDICAL BEHAVIORAL HEALTH CORP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner
2363LP0808XPsychiatric/Mental Health Nurse Practitioner
3106S00000XBehavior Technician

General Provider Information

NPI Number : 1437019759
Entity Type Code : Organization
Provider Name (Legal Business Name) : JD MEDICAL BEHAVIORAL HEALTH CORP
Provider Business Mailing Address
First Line : 3601 W SAHARA AVE STE 101
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-5818
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3601 W SAHARA AVE STE 101
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-5818
Country : US
Telephone Number : 725-255-7865
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MARIA JILL BUENA ALFONSO
Credential :
Telephone Number : 725-255-7865
Provider Enumeration Date : 11/18/2025
Last Update Date : 11/18/2025

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