Active NPI
Victor Fernandes
- Behavior Technician
- Kamuela, HI
National Provider Identifier
1992240980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-16-12894
- Practice address
- 65-1279 Kawaihae Rd Suite 208
Kamuela, HI 96743 - Phone
- (808) 491-9661
- NPI assigned
- Dec 29, 2016
- Sex
- Male
- 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 | RBT-16-12894 | HI | Primary |
Addresses
Primary practice location
65-1279 Kawaihae Rd Suite 208
Kamuela, HI 96743
Mailing address
PO Box 385021
Waikoloa, HI 96738-5021
Phone (561) 386-9800
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-16-12894 | HI | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1482969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1482969600000",
"number": "1992240980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 385021",
"city": "WAIKOLOA",
"state": "HI",
"postal_code": "967385021",
"telephone_number": "561-386-9800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "65-1279 KAWAIHAE RD SUITE 208",
"city": "KAMUELA",
"state": "HI",
"postal_code": "96743",
"telephone_number": "808-491-9661"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERNANDES",
"first_name": "VICTOR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-12-29",
"last_updated": "2016-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "HI",
"license": "RBT-16-12894",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kamuela, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.