Healthcare Provider Details

I. General information

NPI: 1063196319
Provider Name (Legal Business Name): SHARON CISTERNAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2023
Last Update Date: 03/06/2025
Certification Date: 03/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

963 HONOKAHUA PL
HONOLULU HI
96825-3032
US

IV. Provider business mailing address

963 HONOKAHUA PL
HONOLULU HI
96825-3032
US

V. Phone/Fax

Practice location:
  • Phone: 808-673-6284
  • Fax: 808-909-2004
Mailing address:
  • Phone: 808-673-6284
  • Fax: 808-909-2004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: SHARON CISTERNAS
Title or Position: OWNER
Credential: LCSW
Phone: 808-673-6284