MEDICARE: DR. RONELLE SATO PSY.D.

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	103TC0700X	Clinical Psychologist	PSY-1450	HI

General Provider Information

NPI Number	:	1073938692
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONELLE SATO PSY.D.

Provider Business Mailing Address
First Line	:	PO BOX 12182
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96828-1182
Country	:	US
Telephone Number	:	808-398-9859
Fax Number	:

Provider Business Practice Location Address
First Line	:	615 PIIKOI ST STE 1109
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96814-3141
Country	:	US
Telephone Number	:	808-398-9859
Fax Number	:

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

Provider Enumeration Date	:	02/19/2014
Last Update Date	:	02/19/2014

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