Provider Demographics
NPI:1164302774
Name:CABAGUA, JAYLIN (COTA/L)
Entity type:Individual
Prefix:
First Name:JAYLIN
Middle Name:
Last Name:CABAGUA
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 MADRONE DR
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-0162
Mailing Address - Country:US
Mailing Address - Phone:702-809-8328
Mailing Address - Fax:
Practice Address - Street 1:9480 S EASTERN AVE STE 273
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-8000
Practice Address - Country:US
Practice Address - Phone:702-463-5460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-04
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVOTA-3001224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant