Leesha-Ann L.a. Domingo

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

BA-602-0 Issued in HI

Practice address

47-653 Kamehameha Hwy Ste 205
Kaneohe, HI 96744-4965

Phone

(808) 358-2991

Fax

(808) 239-9763

NPI assigned

Jan 9, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Behavioral Health & Family Management

  • Behavior Analyst
  • Kaneohe, HI
  • NPI 1861147357
  NPD Authorized official

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

{
    "created_epoch": "1515456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648598400000",
    "number": "1962919100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47-241 HUI IWA ST APT C",
            "city": "KANEOHE",
            "state": "HI",
            "postal_code": "967444344",
            "telephone_number": "808-358-2991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47-653 KAMEHAMEHA HWY STE 205",
            "city": "KANEOHE",
            "state": "HI",
            "postal_code": "967444965",
            "telephone_number": "808-358-2991",
            "fax_number": "808-239-9763"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "45-955 Kamehameha Hwy # 404-405",
            "address_purpose": "LOCATION",
            "city": "Kaneohe",
            "state": "HI",
            "postal_code": "967443222",
            "country_code": "US",
            "telephone_number": "808-247-2973",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "203 Kapaa Quarry Pl",
            "address_2": "5002",
            "address_purpose": "LOCATION",
            "city": "Kailua",
            "state": "HI",
            "postal_code": "96734",
            "country_code": "US",
            "telephone_number": "808-247-2973",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOMINGO",
        "first_name": "LEESHA-ANN",
        "middle_name": "L.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-09",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "HI",
            "license": "BA-602-0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Kaneohe, HI
• Providers in Kaneohe, HI by specialty
• Behavior Analyst in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.

Verify at the official NPI Registry.