Provider Demographics
NPI:1669964995
Name:PERKINS, SHAYNA (BCABA)
Entity type:Individual
Prefix:
First Name:SHAYNA
Middle Name:
Last Name:PERKINS
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5040 HEKILI RD
Mailing Address - Street 2:
Mailing Address - City:KAPAA
Mailing Address - State:HI
Mailing Address - Zip Code:96746-2028
Mailing Address - Country:US
Mailing Address - Phone:808-651-6700
Mailing Address - Fax:
Practice Address - Street 1:3175 ELUA ST STE B
Practice Address - Street 2:
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-1203
Practice Address - Country:US
Practice Address - Phone:808-246-4808
Practice Address - Fax:808-246-4809
Is Sole Proprietor?:No
Enumeration Date:2018-06-01
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI0188648106E00000X
HIBA-889103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst