Active NPI
Jaclyn Joe, M.ED, BCBA
- Behavior Analyst
- Keaau, HI
National Provider Identifier
1003291972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 66
- Practice address
- 15-1783 Railroad Ave
Keaau, HI 96749 - Phone
- (714) 213-2061
- NPI assigned
- Jul 21, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-15-18756 | HI | |
| Behavior Analyst | 103K00000X | 66 | HI | Primary |
Addresses
Primary practice location
15-1783 Railroad Ave
Keaau, HI 96749
Mailing address
16-566 Keaau Pahoa Rd Ste 188-671
Keaau, HI 96749-8137
Phone (714) 213-2061
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 66 | HI | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684368000000",
"number": "1003291972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16-566 KEAAU PAHOA RD STE 188-671",
"city": "KEAAU",
"state": "HI",
"postal_code": "967498137",
"telephone_number": "714-213-2061"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15-1783 RAILROAD AVE",
"city": "KEAAU",
"state": "HI",
"postal_code": "96749",
"telephone_number": "714-213-2061"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOE",
"first_name": "JACLYN",
"credential": "M.ED, BCBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-07-21",
"last_updated": "2023-05-18",
"certification_date": "2023-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "HI",
"license": "1-15-18756",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "HI",
"license": "66",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Keaau, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.