Kyanna Y Hawkins-Deravin, RBT

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

46 Elizabeth St
Pemberton, NJ 08068-1216

Phone

(609) 316-0195

NPI assigned

Feb 19, 2019

Last updated

Mar 21, 2019By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1550534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553126400000",
    "number": "1538625199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 ELIZABETH ST",
            "city": "PEMBERTON",
            "state": "NJ",
            "postal_code": "080681216",
            "telephone_number": "609-316-0195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 ELIZABETH ST",
            "city": "PEMBERTON",
            "state": "NJ",
            "postal_code": "080681216",
            "telephone_number": "609-316-0195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWKINS-DERAVIN",
        "first_name": "KYANNA",
        "middle_name": "Y",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-19",
        "last_updated": "2019-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick T Griggs
• Eileen Gunson, AT
• Deena Gutch, CADC
• Sara Guzik
• Justin B Harris
• Stephanie Jenifer, LPN
• Meghan Jordan
• Emma Keefe
• Mikayla Kelley
• Michael S Kellner, DC

• Behavior Technician in Pemberton, NJ
• Providers in Pemberton, NJ by specialty
• Behavior Technician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2019; 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.