Active NPI
Krystn M Potenza, RBT
- Behavior Technician
- Mililani, HI
National Provider Identifier
1801547898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 95-1013 Ainamakua Dr
Mililani, HI 96789-5388 - Phone
- (845) 705-8675
- NPI assigned
- Jan 12, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | NY | Primary |
Addresses
Primary practice location
95-1013 Ainamakua Dr
Mililani, HI 96789-5388
Mailing address
1390 Miller St
Honolulu, HI 96813-2493
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1641945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641945600000",
"number": "1801547898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1390 MILLER ST",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968132493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "95-1013 AINAMAKUA DR",
"city": "MILILANI",
"state": "HI",
"postal_code": "967895388",
"telephone_number": "845-705-8675"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POTENZA",
"first_name": "KRYSTN",
"middle_name": "M",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-01-12",
"last_updated": "2022-01-12",
"certification_date": "2022-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NY",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mililani, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.