MEDICARE: JASMINE MARIE PEREZ

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	RBT2835	NV

General Provider Information

NPI Number	:	1760292106
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASMINE MARIE PEREZ

Provider Business Mailing Address
First Line	:	9774 GALLO DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-6744
Country	:	US
Telephone Number	:	702-533-2830
Fax Number	:

Provider Business Practice Location Address
First Line	:	2480 MAVERICK ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89108-3824
Country	:	US
Telephone Number	:	702-799-4550
Fax Number	:

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

Provider Enumeration Date	:	01/08/2025
Last Update Date	:	01/08/2025

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Directions to “ JASMINE MARIE PEREZ ” Practice Location

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