Provider Demographics
NPI:1417316019
Name:SIMON, JESSICA LYNDA GARCIA (BCBA,LBA)
Entity Type:Individual
Prefix:
First Name:JESSICA LYNDA
Middle Name:GARCIA
Last Name:SIMON
Suffix:
Gender:F
Credentials:BCBA,LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3057 CHOLLAR CIR
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89434-1707
Mailing Address - Country:US
Mailing Address - Phone:775-250-0746
Mailing Address - Fax:
Practice Address - Street 1:3785 BAKER LN
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-5453
Practice Address - Country:US
Practice Address - Phone:209-505-0634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-11
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVLABA0302106E00000X
NVLBA0526103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst