Melissa Denise Theriaque

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

2649 Ipu Wai LN
Wahiawa, HI 96786-7004

Phone

(931) 538-5587

NPI assigned

Jun 18, 2022

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": "1655510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683504000000",
    "number": "1821729187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2003 S EASTON RD",
            "city": "DOYLESTOWN",
            "state": "PA",
            "postal_code": "189017100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2649 IPU WAI LN",
            "city": "WAHIAWA",
            "state": "HI",
            "postal_code": "967867004",
            "telephone_number": "931-538-5587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THERIAQUE",
        "first_name": "MELISSA",
        "middle_name": "DENISE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-18",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "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 Wahiawa, HI
• Providers in Wahiawa, HI by specialty
• Behavior Technician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 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.