MEDICARE: BRENDA JACKSON

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
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1538509526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENDA JACKSON

Provider Business Mailing Address
First Line	:	5135 CAMINO AL NORTE
Second Line	:	SUITE 255
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-2387
Country	:	US
Telephone Number	:	702-483-5949
Fax Number	:	702-853-6717

Provider Business Practice Location Address
First Line	:	5135 CAMINO AL NORTE
Second Line	:	SUITE 255
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-2387
Country	:	US
Telephone Number	:	702-483-5949
Fax Number	:	702-853-6717

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2013
Last Update Date	:	07/05/2013

Similar Medicare Providers

1962693465 — MS. DAWN L STARKS-BALL LCSW
Practice Location Address:

5135 CAMINO AL NORTE
NORTH LAS VEGAS, NV
89031-2387

Practice Phone: 702-550-8750
Practice Fax: 702-974-8629

1609148337 — COREY A MOORE LCPC-I
Practice Location Address:

5135 CAMINO AL NORTE
NORTH LAS VEGAS, NV
89031-2387

Practice Phone: 702-405-5423
Practice Fax: 702-853-7001

1174960348 — JAZMINE ORR
Practice Location Address:

5135 CAMINO AL NORTE , STE. 259
NORTH LAS VEGAS, NV
89031-2387

Practice Phone: 702-544-5654
Practice Fax:

1386084374 — WILLIAM C LANE III
Practice Location Address:

5135 CAMINO AL NORTE , SUITE 255
NORTH LAS VEGAS, NV
89031-2387

Practice Phone: 702-853-6716
Practice Fax: 702-853-6717

1790118990 — KEYSA L ROGERS
Practice Location Address:

5135 CAMINO AL NORTE , SUITE 256
NORTH LAS VEGAS, NV
89031-2387

Practice Phone: 702-853-7053
Practice Fax: 702-853-7054

1568897981 — CELESTE T MARTIAL
Practice Location Address:

5135 CAMINO AL NORTE , SUITE 255
NORTH LAS VEGAS, NV
89031-2387

Practice Phone: 702-853-6716
Practice Fax:

Directions to “ BRENDA JACKSON ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.