Heather Bouma – Behavior Technician in Waianae, HI

Key facts

NPI: 1497480677
Entity type: Individual (NPI type 1)
Primary specialty: Behavior Technician 106S00000X
Practice address: 87-1720 Farrington Hwy Apt 4
Waianae, HI 96792-3766
Phone: (254) 258-2752
NPI assigned: Jul 20, 2022
Sex: Female
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

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Behavior Technician	106S00000X			Yes

Addresses

Primary practice location

87-1720 Farrington Hwy Apt 4
Waianae, HI 96792-3766

Mailing address

7108 S Kanner Hwy
Stuart, FL 34997-7462

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 20, 2022.

{
    "created_epoch": "1658275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1497480677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7108 S KANNER HWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349977462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87-1720 FARRINGTON HWY APT 4",
            "city": "WAIANAE",
            "state": "HI",
            "postal_code": "967923766",
            "telephone_number": "254-258-2752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUMA",
        "first_name": "HEATHER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-20",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waianae, HI

All providers in Waianae, HI · Behavior Technician in Hawaii

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 20, 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.

Verify at the official NPI Registry.