Healthcare Provider Details

I. General information

NPI: 1245825140
Provider Name (Legal Business Name): BOARD OF REGENTS NEVADA SYSTEM OF HIGHER EDUCATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2021
Last Update Date: 03/08/2021
Certification Date: 03/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1664 N VIRGINIA STREET CAIN HALL ROOM 239
RENO NV
89557-0001
US

IV. Provider business mailing address

1664 N VIRGINIA ST MAILSTOP 0296
RENO NV
89557-0001
US

V. Phone/Fax

Practice location:
  • Phone: 775-682-8686
  • Fax: 775-784-1126
Mailing address:
  • Phone: 775-682-8686
  • Fax: 775-784-1126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH JACOBSEN
Title or Position: ADMINISTRATIVE ASSISTANT III
Credential:
Phone: 775-682-8686