Healthcare Provider Details

I. General information

NPI: 1285884361
Provider Name (Legal Business Name): JOAN SHIRLEY PARKER-DIAS RNC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2008
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7192 KALANIANAOLE HWY STE D214
HONOLULU HI
96825-1855
US

IV. Provider business mailing address

1314 AKELE ST
KAILUA HI
96734-4223
US

V. Phone/Fax

Practice location:
  • Phone: 808-909-2006
  • Fax: 808-909-3818
Mailing address:
  • Phone: 808-292-5380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License NumberRN34426
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1186
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: