Healthcare Provider Details

I. General information

NPI: 1619896883
Provider Name (Legal Business Name): CASTON JASE RAY COZART RBT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1698 MEADOW WOOD LN
RENO NV
89502-6707
US

IV. Provider business mailing address

6604 FIREBURST DR
SPARKS NV
89436-9176
US

V. Phone/Fax

Practice location:
  • Phone: 775-637-0030
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: