MEDICARE: SHERRI ANN K. KAAHANUI PSYD, CSAC

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	1552	HI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	PSY-1552	OTHER	HI	LICENSE NUMBER

General Provider Information

NPI Number	:	1255706081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERRI ANN K. KAAHANUI PSYD, CSAC

Provider Business Mailing Address
First Line	:	1109 12TH AVE STE 201
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96816-3714
Country	:	US
Telephone Number	:	808-927-8746
Fax Number	:	808-466-8313

Provider Business Practice Location Address
First Line	:	1109 12TH AVE STE 201
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96816-3714
Country	:	US
Telephone Number	:	808-927-8746
Fax Number	:

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

Provider Enumeration Date	:	12/04/2015
Last Update Date	:	03/11/2024

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