Provider Demographics
NPI:1114643731
Name:TREVINO, BRANDI (RBT)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:
Last Name:TREVINO
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 PAPALOA RD APT 1002
Mailing Address - Street 2:
Mailing Address - City:KAPAA
Mailing Address - State:HI
Mailing Address - Zip Code:96746-1421
Mailing Address - Country:US
Mailing Address - Phone:808-647-4449
Mailing Address - Fax:
Practice Address - Street 1:401 PAPALOA RD APT 1002
Practice Address - Street 2:
Practice Address - City:KAPAA
Practice Address - State:HI
Practice Address - Zip Code:96746-1421
Practice Address - Country:US
Practice Address - Phone:808-647-4449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-14
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician