Jennifer Wakeley

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-22-211200 Issued in HI

Practice address

1895 Haleukana St
Lihue, HI 96766-9072

Phone

(808) 346-6690

Fax

(888) 461-0904

NPI assigned

Apr 11, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Pakolea Support Services

  • Behavior Analyst
  • Lihue, HI
  • NPI 1770183980
  NPD
• Pakolea Support Services

  • Multi-Specialty Clinic/Center
  • Lihue, HI
  • NPI 1831861913
  NPD

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

{
    "created_epoch": "1649635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649635200000",
    "number": "1376285296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4151 MOMI ST",
            "city": "KILAUEA",
            "state": "HI",
            "postal_code": "967545312",
            "telephone_number": "808-639-5896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1895 HALEUKANA ST",
            "city": "LIHUE",
            "state": "HI",
            "postal_code": "967669072",
            "telephone_number": "808-346-6690",
            "fax_number": "888-461-0904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAKELEY",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-11",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "HI",
            "license": "RBT-22-211200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BACB",
            "identifier": "RBT-22-211200",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Stacie Waiamau
• Kaylen Toshio Wakumoto, D.P.T
• Tiffany K Wakumoto, D.P.T.
• Walmart Inc.
• Mary Weckback, RDH, OMT
• Elicia M. Wetherington

• Behavior Technician in Lihue, HI
• Providers in Lihue, HI by specialty
• Behavior Technician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 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.

Verify at the official NPI Registry.