Revelyn Domingsil Jacinto, PRIMARY CAREGIVER

Primary specialty

Nurse's AideTaxonomy code 376K00000X

License

HI110118067 Issued in HI

Practice address

94-913 Kahuailani St
Waipahu, HI 96797-3326

Phone

(808) 671-2605

Fax

(808) 671-2603

NPI assigned

Oct 9, 2015

Last updated

Oct 9, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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": "1444348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444348800000",
    "number": "1770954265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94-913 KAHUAILANI ST",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967973326",
            "telephone_number": "808-671-2605",
            "fax_number": "808-671-2603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94-913 KAHUAILANI ST",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967973326",
            "telephone_number": "808-671-2605",
            "fax_number": "808-671-2603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACINTO",
        "first_name": "REVELYN",
        "middle_name": "DOMINGSIL",
        "name_prefix": "Mrs.",
        "credential": "PRIMARY CAREGIVER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-09",
        "last_updated": "2015-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "HI",
            "license": "HI110118067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS LICENSE",
            "identifier": "H01270651",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIMARY CAREGIVER",
            "identifier": "1-150047",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nurse's Aide in Waipahu, HI
• Providers in Waipahu, HI by specialty
• Nurse's Aide in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2015; 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.