Individual provider Active NPI

Jeanette Perez

  • Behavior Technician
  • Hilo, HI
National Provider Identifier
1336475243
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
1221 Kilauea Ave Ste 60
Hilo, HI 96720-4264
Phone
(808) 969-2253
NPI assigned
Oct 27, 2009
Last updated
Jun 21, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

1221 Kilauea Ave Ste 60
Hilo, HI 96720-4264

Mailing address

1221 Kilauea Ave Ste 60
Hilo, HI 96720-4264
Phone (808) 969-2253

Other practice location 1

622 Hinano St
Hilo, HI 96720-4427
Phone (808) 589-1829 ext. 114

Other practice location 2

622 Hinano St
Hilo, HI 96720-4427
Phone (808) 589-1829 ext. 114

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bayada Home Care Past Accepting new patients
B.C.P., Inc. Dba/ Bayada Home Health Care Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1256601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529539200000",
    "number": "1336475243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 KILAUEA AVE STE 60",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967204264",
            "telephone_number": "808-969-2253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 KILAUEA AVE STE 60",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967204264",
            "telephone_number": "808-969-2253"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "622 Hinano St",
            "address_purpose": "LOCATION",
            "city": "Hilo",
            "state": "HI",
            "postal_code": "967204427",
            "country_code": "US",
            "telephone_number": "808-589-1829 x114",
            "fax_number": "808-589-2610",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "622 Hinano St",
            "address_purpose": "LOCATION",
            "city": "Hilo",
            "state": "HI",
            "postal_code": "967204427",
            "country_code": "US",
            "telephone_number": "808-589-1829 x114",
            "fax_number": "808-589-2610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "JEANETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-27",
        "last_updated": "2018-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilo, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.