Kelsie Reiko Nani Dela Cruz

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

BA-638 Issued in HI

Practice address

420 Waiakamilo Rd #202
Honolulu, HI 96817-5119

Phone

(808) 845-0102

NPI assigned

Dec 15, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kelsie Reiko Nani Lau Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Autism Intervention Management Incorporated

  • Developmental Disabilities Clinic/Center
  • Honolulu, HI
  • NPI 1215545991
  NPD (past)

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

{
    "created_epoch": "1513296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1760998538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 WAIAKAMILO RD #202",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968175119",
            "telephone_number": "808-393-9826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 WAIAKAMILO RD #202",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968175119",
            "telephone_number": "808-845-0102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELA CRUZ",
        "first_name": "KELSIE",
        "middle_name": "REIKO NANI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-15",
        "last_updated": "2024-10-10",
        "certification_date": "2022-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "HI",
            "license": "BA-638-0",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "HI",
            "license": "BA-638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSIE",
            "last_name": "LAU",
            "middle_name": "REIKO NANI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hidemi Dela Cruz, FNP-BC
• Ignacio Joaquin Cosico Dela Cruz
• Jas Rick Dela Cruz, RBT
• Jessel Lyn Cablay Dela Cruz, PHARMD
• Joseph Gary Dela Cruz, M.D.
• Lorlyn F Dela Cruz, RN
• Maria Excellsis Dela Cruz, PA-C
• Carl John Dela Pena, DPT
• Shyanne Santos Dela Vega, DNP, APRN-RX, FNP-BC
• Marie Angeline Delabarrera, LMHC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2024; 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.