=====================================================
General NPI Number Information
=====================================================
NPI Number | 1073164471
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHIEDOZIE ORJI BCBA
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/26/2019
-----------------------------------------------------
Last Update Date | 01/06/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1330 ALA MOANA BLVD STE 1
-----------------------------------------------------
City | HONOLULU
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96814-4262
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-585-1424
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1331 ALA KAPUNA ST APT 208
-----------------------------------------------------
City | HONOLULU
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96819-1315
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-376-9821
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number | BA-737-0
-----------------------------------------------------
License Number State | HI
-----------------------------------------------------