Healthcare Provider Details

I. General information

NPI: 1629584933
Provider Name (Legal Business Name): PRECIOUS YASAY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/21/2017
Last Update Date: 12/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45-955 KAMEHAMEHA HWY
KANEOHE HI
96744-3222
US

IV. Provider business mailing address

45-955 KAMEHAMEHA HWY
KANEOHE HI
96744-3222
US

V. Phone/Fax

Practice location:
  • Phone: 808-247-2973
  • Fax:
Mailing address:
  • Phone: 808-247-2973
  • Fax: 808-427-3472

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: