Active NPI
Diane Criserleene Mateo
- Behavior Technician
- Honolulu, HI
National Provider Identifier
1093456626
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 1390 Miller St
Honolulu, HI 96813-2493 - Phone
- (808) 381-8907
- NPI assigned
- Apr 6, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
1390 Miller St
Honolulu, HI 96813-2493
Mailing address
94-352 Kahuahele St
Waipahu, HI 96797-3465
Phone (808) 551-3992
Other practice location 1
4510 Salt Lake Blvd Ste C4
Honolulu, HI 96818-3171
Phone (808) 486-1804
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| R000080140999 | Medicaid | HI |
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": "1649203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695686400000",
"number": "1093456626",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "94-352 KAHUAHELE ST",
"city": "WAIPAHU",
"state": "HI",
"postal_code": "967973465",
"telephone_number": "808-551-3992"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1390 MILLER ST",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968132493",
"telephone_number": "808-381-8907"
}
],
"practiceLocations": [
{
"address_1": "4510 Salt Lake Blvd Ste C4",
"address_purpose": "LOCATION",
"city": "Honolulu",
"state": "HI",
"postal_code": "968183171",
"country_code": "US",
"telephone_number": "808-486-1804",
"fax_number": "808-486-9199",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MATEO",
"first_name": "DIANE CRISERLEENE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-04-06",
"last_updated": "2023-09-26",
"certification_date": "2023-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "R000080140999",
"state": "HI"
}
],
"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 Sep 26, 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.