Active NPI
Mary Jane Dela Pena
- Attendant Care Provider
- Waipahu, HI
National Provider Identifier
1326765124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Attendant Care Provider
- License
- 1631300
- Practice address
- 94-1336 Huakai St
Waipahu, HI 96797-3839 - Phone
- (808) 676-4551
- Fax
- (808) 676-4551
- NPI assigned
- Oct 21, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Attendant Care Provider | 3747A0650X | 1631300 | HI | Primary |
Addresses
Primary practice location
94-1336 Huakai St
Waipahu, HI 96797-3839
Mailing address
94-1336 Huakai St
Waipahu, HI 96797-3839
Phone (808) 676-4551
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1631300 | HI | MD | Attendant Care Provider |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666310400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666310400000",
"number": "1326765124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "94-1336 HUAKAI ST",
"city": "WAIPAHU",
"state": "HI",
"postal_code": "967973839",
"telephone_number": "808-676-4551",
"fax_number": "808-676-4551"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "94-1336 HUAKAI ST",
"city": "WAIPAHU",
"state": "HI",
"postal_code": "967973839",
"telephone_number": "808-676-4551",
"fax_number": "808-676-4551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELA PENA",
"first_name": "MARY JANE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-10-21",
"last_updated": "2022-10-21",
"certification_date": "2022-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "3747A0650X",
"taxonomy_group": "",
"desc": "Technician, Attendant Care Provider",
"state": "HI",
"license": "1631300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waipahu, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.