Tyron De Vera Chavez
Individual provider Active NPI Behavior Technician · Keaau, HI
NPI 1154030112 · NPPES record last updated Nov 18, 2022
Key facts
- NPI
- 1154030112
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- License
- RBT-22-242621 (HI)
- Practice address
- 9 1/2 Mile Camp #21
Keaau, HI 96749 - Phone
- (808) 491-3632
- NPI assigned
- Nov 18, 2022
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-22-242621 | HI | MD | Behavior Technician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-22-242621 | HI | Yes |
Addresses
Primary practice location
9 1/2 Mile Camp #21
Keaau, HI 96749
Mailing address
PO Box 2118
Keaau, HI 96749-2118
Phone (808) 491-3632
Other providers in Keaau, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 18, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.