Healthcare Provider Details

I. General information

NPI: 1497641443
Provider Name (Legal Business Name): SUZETTE GUILLERMO TIANGCO RN, CDCES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUZETTE GUILLERMO

II. Dates (important events)

Enumeration Date: 06/16/2025
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1380 LUSITANA ST STE B-5
HONOLULU HI
96813-2449
US

IV. Provider business mailing address

1706 NOE ST
HONOLULU HI
96819-3852
US

V. Phone/Fax

Practice location:
  • Phone: 808-691-4823
  • Fax: 808-691-5399
Mailing address:
  • Phone: 808-636-5052
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number32309949
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: