Shane Ann Tejada Cobacha

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

4510 Salt Lake Blvd Ste D8
Honolulu, HI 96818-3172

Phone

(808) 486-1804

NPI assigned

Jun 21, 2021

Last updated

Sep 14, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1624233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694649600000",
    "number": "1811566284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4510 SALT LAKE BLVD STE D8",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968183172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4510 SALT LAKE BLVD STE D8",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968183172",
            "telephone_number": "808-486-1804"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "94-428 Mokuola St Ste 214A",
            "address_purpose": "LOCATION",
            "city": "Waipahu",
            "state": "HI",
            "postal_code": "967973396",
            "country_code": "US",
            "telephone_number": "808-944-2882",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COBACHA",
        "first_name": "SHANE ANN",
        "middle_name": "TEJADA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-21",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "HI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2023; 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.