Healthcare Provider Details

I. General information

NPI: 1275449340
Provider Name (Legal Business Name): KRYCHEL LYNN LIMO QUENGA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHELLY LYNN LIMO QUENGA

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2155 KALAKAUA AVE STE 701
HONOLULU HI
96815-2341
US

IV. Provider business mailing address

PO BOX 630363
LANAI CITY HI
96763-0363
US

V. Phone/Fax

Practice location:
  • Phone: 808-501-2362
  • Fax: 630-521-5610
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-2841815
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: