Individual provider Active NPI

Tyarra Kealakai

  • Behavior Technician
  • Waipahu, HI
National Provider Identifier
1578156808
Registry record updated Feb 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
20-137646 Issued in HI
Practice address
94-450 Mokuola St Ste 100
Waipahu, HI 96797-3388
Phone
(808) 800-6400
NPI assigned
Feb 17, 2021
Last updated
Feb 17, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X 20-137646 HI Primary

Addresses

Primary practice location

94-450 Mokuola St Ste 100
Waipahu, HI 96797-3388

Mailing address

1047 Ala Napunani St Apt 204
Honolulu, HI 96818-1753
Phone (808) 800-6400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
20-137646HIMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1613520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613520000000",
    "number": "1578156808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1047 ALA NAPUNANI ST APT 204",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968181753",
            "telephone_number": "808-800-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94-450 MOKUOLA ST STE 100",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967973388",
            "telephone_number": "808-800-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEALAKAI",
        "first_name": "TYARRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-17",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "HI",
            "license": "20-137646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waipahu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2021; 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.