Healthcare Provider Details

I. General information

NPI: 1346046224
Provider Name (Legal Business Name): DANIEL MATTOX NURSING CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2025
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 ALA MOANA BLVD STE 7400
HONOLULU HI
96813-4902
US

IV. Provider business mailing address

500 ALA MOANA BLVD STE 7400
HONOLULU HI
96813-4902
US

V. Phone/Fax

Practice location:
  • Phone: 85-634-1288
  • Fax:
Mailing address:
  • Phone: 808-563-4128
  • Fax: 619-415-8415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DANIEL THOMAS MATTOX
Title or Position: OWNER
Credential: PMHNP-BC
Phone: 626-848-6670