Provider Demographics
NPI:1063901155
Name:BOARD OF REGENTS, NEVADA SYSTEM OF HIGHER EDUCATION
Entity type:Organization
Organization Name:BOARD OF REGENTS, NEVADA SYSTEM OF HIGHER EDUCATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT II
Authorized Official - Prefix:MRS
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CERVANTES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-682-8686
Mailing Address - Street 1:1664 NORTH VIRGINIA STREET
Mailing Address - Street 2:PSYCHOLOGY DEPARTMENT/MAIL STOP 296
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89557
Mailing Address - Country:US
Mailing Address - Phone:775-682-8686
Mailing Address - Fax:775-784-1126
Practice Address - Street 1:604 WEST MOANA LANE
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509
Practice Address - Country:US
Practice Address - Phone:775-682-8686
Practice Address - Fax:775-784-1126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-04
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106E00000X, 106S00000X
NVLBA0001103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty