Individual provider Active NPI

Gina Gwak

  • Behavior Technician
  • Tamuning, GU
National Provider Identifier
1770181067
Registry record updated Oct 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
212 Farenholt Ave
Tamuning, GU 96913
Phone
(671) 483-4747
NPI assigned
Oct 9, 2020
Last updated
Oct 9, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2020

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 GU Primary

Addresses

Primary practice location

212 Farenholt Ave
Tamuning, GU 96913

Mailing address

212 Farenholt Ave
Tamuning, GU 96913
Phone (671) 483-4747

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hunterspeaks Organization Behavior Technician CurrentSince Apr 11, 2021 Accepting new patients

Locations

212 Farenholt Ave
Tamuning, GU 96913
Phone (671) 483-4747

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1602201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602201600000",
    "number": "1770181067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 FARENHOLT AVE",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "96913",
            "telephone_number": "671-483-4747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 FARENHOLT AVE",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "96913",
            "telephone_number": "671-483-4747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GWAK",
        "first_name": "GINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-09",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "GU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tamuning, GU

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2020; 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.