Fernanda Ibarra Bray

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

21-187872 Issued in HI

Practice address

46-1016 Emepela Way Apt 22T
Kaneohe, HI 96744-3908

Phone

(606) 275-5225

NPI assigned

Nov 16, 2022

Last updated

Nov 16, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Fernanda Ibarra Gonzalez Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1668556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668556800000",
    "number": "1427767680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46-1016 EMEPELA WAY APT 22T",
            "city": "KANEOHE",
            "state": "HI",
            "postal_code": "967443908",
            "telephone_number": "606-275-5225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46-1016 EMEPELA WAY APT 22T",
            "city": "KANEOHE",
            "state": "HI",
            "postal_code": "967443908",
            "telephone_number": "606-275-5225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAY",
        "first_name": "FERNANDA",
        "middle_name": "IBARRA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-16",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "HI",
            "license": "21-187872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FERNANDA",
            "last_name": "GONZALEZ",
            "middle_name": "IBARRA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.