MEDICARE: LEEWARD THERAPY AND COMMUNITY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QM0850X	Adult Mental Health Clinic/Center
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
3	251S00000X	Community/Behavioral Health Agency

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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275289407
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEEWARD THERAPY AND COMMUNITY

Provider Business Mailing Address
First Line	:	91-1170 MIKOHU ST APT C
Second Line	:
City	:	EWA BEACH
State	:	HI
Zip	:	96706-4317
Country	:	US
Telephone Number	:	808-466-9111
Fax Number	:

Provider Business Practice Location Address
First Line	:	91-1170 MIKOHU ST APT 40C
Second Line	:
City	:	EWA BEACH
State	:	HI
Zip	:	96706-4317
Country	:	US
Telephone Number	:	505-429-5731
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TARYN JOY MAI VALDEZ IVERS
Credential	:
Telephone Number	:	808-466-9111

Provider Enumeration Date	:	02/25/2022
Last Update Date	:	04/16/2026

Similar Medicare Providers

1043683410 — DEVIN BELDING
Practice Location Address:

91-1170 MIKOHU ST APT 40U
EWA BEACH, HI
96706-4317

Practice Phone: 808-389-0051
Practice Fax:

1730974619 — LEEWARD THERAPY AND COMMUNITY SUPPORTS
Practice Location Address:

91-1170 MIKOHU ST APT 40C
EWA BEACH, HI
96706-4317

Practice Phone: 808-466-9111
Practice Fax:

1497736193 — MARIBEL CONCEPION MUNOZ NP-C
Practice Location Address:

200 OCEANGATE STE 100
LONG BEACH, CA
90802-4317

Practice Phone: 562-435-3666
Practice Fax: 562-499-6197

1780609834 — DR. DIANE LYNN CHAU MD
Practice Location Address:

200 OCEANGATE STE 100
LONG BEACH, CA
90802-4317

Practice Phone: 888-562-5442
Practice Fax:

1164435582 — MS. PATRICIA A KELLY NMD, FNP-BC, GNPC-BC
Practice Location Address:

200 OCEANGATE STE 100
LONG BEACH, CA
90802-4317

Practice Phone: 888-562-5442
Practice Fax: 562-528-5595

1194811760 — MOLINA HEALTHCARE OF CALIFORNIA
Practice Location Address:

200 OCEANGATE STE 100
LONG BEACH, CA
90802-4317

Practice Phone: 562-499-6191
Practice Fax: 562-499-6171

Directions to “LEEWARD THERAPY AND COMMUNITY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.