Healthcare Provider Details

I. General information

NPI: 1891556833
Provider Name (Legal Business Name): KATHERINE FARDEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2024
Last Update Date: 05/17/2026
Certification Date: 05/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1847 S KIHEI RD STE 104-105
KIHEI HI
96753-7939
US

IV. Provider business mailing address

1847 S KIHEI RD STE 104-105
KIHEI HI
96753-7939
US

V. Phone/Fax

Practice location:
  • Phone: 808-879-4111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: