Sophie M Bourret, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

BA-758 Issued in HI

Practice address

203 Kapaa Quarry PL
#5002
Kailua, HI 96734

Phone

(808) 247-2973

Fax

(808) 427-3472

NPI assigned

Nov 6, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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": "1541462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1548738735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 KALANIANAOLE HWY SPC 5001",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967344669",
            "telephone_number": "808-247-2973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 KAPAA QUARRY PL",
            "address_2": "#5002",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "96734",
            "telephone_number": "808-247-2973",
            "fax_number": "808-427-3472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURRET",
        "first_name": "SOPHIE",
        "middle_name": "M",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-06",
        "last_updated": "2023-03-27",
        "certification_date": "2022-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "HI",
            "license": "0-22-13497",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "HI",
            "license": "BA-758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amelia Borofsky, PSYD
• Botox Kailua LLC
• John Jacob Bottorff, M.D.
• Samantha Bouck
• Edward Luke Bourke Jr., MD
• Rachael Bousman, CAT, MED
• Yuko Bowie
• Heather Marie Bradford, M.D.
• Megan Epperson Bradham, MD
• Bradley K. Hook

• Behavior Analyst in Kailua, HI
• Providers in Kailua, HI by specialty
• Behavior Analyst in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; 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.