Provider Demographics
NPI:1649141458
Name:FAGARANG, SKYLAR XAVIER BUENO (RBT)
Entity type:Individual
Prefix:
First Name:SKYLAR XAVIER
Middle Name:BUENO
Last Name:FAGARANG
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99-128 OHEKANI LOOP APT A
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-3769
Mailing Address - Country:US
Mailing Address - Phone:808-561-7288
Mailing Address - Fax:
Practice Address - Street 1:1001 KAMOKILA BLVD STE 210
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-2096
Practice Address - Country:US
Practice Address - Phone:808-591-6060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRBT-25-467719106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician