Healthcare Provider Details

I. General information

NPI: 1467374553
Provider Name (Legal Business Name): CANDACE EMILY STEBBINS IDHS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HALE KAHU MOANA CLINIC 400 SAND ISLAND PARKWAY
FPO AA
96818
US

IV. Provider business mailing address

92-775 WELO ST
KAPOLEI HI
96707-1421
US

V. Phone/Fax

Practice location:
  • Phone: 808-842-2930
  • Fax:
Mailing address:
  • Phone: 808-842-2930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1710I1003X
TaxonomyIndependent Duty Medical Technicians
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: