Individual provider Active NPI

Crystal Pena

  • Behavior Technician
  • Honolulu, HI
National Provider Identifier
1003306341
Registry record updated May 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
3748 Kumukoa PL
Honolulu, HI 96822-1106
Phone
(808) 988-4713
NPI assigned
May 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X HI Primary

Addresses

Primary practice location

3748 Kumukoa PL
Honolulu, HI 96822-1106

Mailing address

4510 Salt Lake Blvd Ste D8
Honolulu, HI 96818-3172

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1525996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525996800000",
    "number": "1003306341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4510 SALT LAKE BLVD STE D8",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968183172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3748 KUMUKOA PL",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968221106",
            "telephone_number": "808-988-4713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "CRYSTAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-11",
        "last_updated": "2018-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "HI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.