Healthcare Provider Details

I. General information

NPI: 1114530615
Provider Name (Legal Business Name): RAMONA LANDRY TAYLOR MA MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RAMONA LANDRY TAYLOR MA

II. Dates (important events)

Enumeration Date: 08/25/2020
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13-581 KAMAILI ROAD
PAHOA HI
96778
US

IV. Provider business mailing address

PO BOX 1529
PAHOA HI
96778-1529
US

V. Phone/Fax

Practice location:
  • Phone: 808-763-7659
  • Fax:
Mailing address:
  • Phone: 808-763-7659
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFT-547
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number97652
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: