Healthcare Provider Details

I. General information

NPI: 1144150210
Provider Name (Legal Business Name): PAMATA TOLEDO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 KUPUOHI ST STE 206
LAHAINA HI
96761-2714
US

IV. Provider business mailing address

40 KUPUOHI ST STE 206
LAHAINA HI
96761-2714
US

V. Phone/Fax

Practice location:
  • Phone: 808-446-4561
  • Fax: 855-940-3108
Mailing address:
  • Phone: 808-446-4561
  • Fax: 855-940-3108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberBACB1564253
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: