Healthcare Provider Details

I. General information

NPI: 1265180731
Provider Name (Legal Business Name): ERIN A MATSUNAGA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2022
Last Update Date: 03/14/2022
Certification Date: 03/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

429 PATTERSON ROAD
HONOLULU HI
96819
US

IV. Provider business mailing address

99-560 ALIIPOE DR
AIEA HI
96701-3301
US

V. Phone/Fax

Practice location:
  • Phone: 808-433-7853
  • Fax:
Mailing address:
  • Phone: 818-917-9675
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number3806
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: