Healthcare Provider Details

I. General information

NPI: 1295404606
Provider Name (Legal Business Name): JOCELINE GUADALUPE TAMBURELLO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2021
Last Update Date: 06/05/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 COLLEGE PKWY
CARSON CITY NV
89706-7944
US

IV. Provider business mailing address

6066 PLUMAS ST APT C
RENO NV
89519-6033
US

V. Phone/Fax

Practice location:
  • Phone: 775-687-0101
  • Fax:
Mailing address:
  • Phone: 760-686-5443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP-4210
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: