Healthcare Provider Details

I. General information

NPI: 1801729215
Provider Name (Legal Business Name): FABIO CARDOSO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1632 S KING ST
HONOLULU HI
96826-2065
US

IV. Provider business mailing address

396 POIPU DR
HONOLULU HI
96825-2125
US

V. Phone/Fax

Practice location:
  • Phone: 808-589-2367
  • Fax:
Mailing address:
  • Phone: 808-429-9416
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: