Healthcare Provider Details

I. General information

NPI: 1528762440
Provider Name (Legal Business Name): KAYLEE CARVALHO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2023
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

905 KALANIANAOLE HWY SPC 5001
KAILUA HI
96734-4669
US

IV. Provider business mailing address

905 KALANIANAOLE HWY SPC 5001
KAILUA HI
96734-4669
US

V. Phone/Fax

Practice location:
  • Phone: 808-247-2973
  • Fax:
Mailing address:
  • Phone: 808-247-2973
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-22-222510
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: