Healthcare Provider Details

I. General information

NPI: 1336001809
Provider Name (Legal Business Name): ASHLYNN CARRERO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2025
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94-450 MOKUOLA ST STE 100
WAIPAHU HI
96797-3388
US

IV. Provider business mailing address

PO BOX 79
WAIANAE HI
96792-0079
US

V. Phone/Fax

Practice location:
  • Phone: 808-944-2882
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: