Healthcare Provider Details

I. General information

NPI: 1699630822
Provider Name (Legal Business Name): CHASE GIESSNER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 E PRATER WAY STE 107
SPARKS NV
89434-8963
US

IV. Provider business mailing address

1625 E PRATER WAY STE 107
SPARKS NV
89434-8963
US

V. Phone/Fax

Practice location:
  • Phone: 775-825-4744
  • Fax: 775-351-1644
Mailing address:
  • Phone: 775-825-4744
  • Fax: 775-351-1644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT6126
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: