Healthcare Provider Details

I. General information

NPI: 1538528773
Provider Name (Legal Business Name): MARITZA OREGON BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2016
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92-1329 PRINCE KUHIO BLVD STE 4
CAPTAIN COOK HI
96704-9214
US

IV. Provider business mailing address

92-1329 PRINCE KUHIO BLVD STE 4
CAPTAIN COOK HI
96704-9214
US

V. Phone/Fax

Practice location:
  • Phone: 808-345-5661
  • Fax:
Mailing address:
  • Phone: 808-345-5661
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number382
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number4314
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number0133005168
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number15BC00374700
License Number StateNJ
# 5
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberLBA000986
License Number StateGA
# 6
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-15-21114
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: