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1417772310

NPI Code Detail

MEDICARE: JASMINE GANDY

MEDICARE: JASMINE GANDY

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	106S00000X	Behavior Technician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	568946544	OTHER		BCBS
2	5874	OTHER		HEALTH PARTNERS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417772310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASMINE GANDY

Provider Business Mailing Address
First Line	:	3716 BACH WAY
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-0628
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5803 W CRAIG RD STE 105
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-2537
Country	:	US
Telephone Number	:	702-901-5200
Fax Number	:

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

Provider Enumeration Date	:	11/18/2024
Last Update Date	:	11/18/2024

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Directions to “ JASMINE GANDY ” 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.

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