MEDICARE: JAYDA NICOLE ELAZIER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician		HI

General Provider Information

NPI Number	:	1508635475
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAYDA NICOLE ELAZIER

Provider Business Mailing Address
First Line	:	1684 SAINT LOUIS DR
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96816-1923
Country	:	US
Telephone Number	:	347-567-2248
Fax Number	:

Provider Business Practice Location Address
First Line	:	1448 LILIHA ST STE 201
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96817-3589
Country	:	US
Telephone Number	:	808-681-2718
Fax Number	:	855-975-2866

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/20/2023
Last Update Date	:	06/05/2026

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Directions to “ JAYDA NICOLE ELAZIER ” Practice Location

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