Healthcare Provider Details

I. General information

NPI: 1326775701
Provider Name (Legal Business Name): OHANA HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2022
Last Update Date: 10/17/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11355 US HIGHWAY 87 S UNIT 2
ADKINS TX
78101-1851
US

IV. Provider business mailing address

11355 US HIGHWAY 87 S UNIT 2
ADKINS TX
78101-1851
US

V. Phone/Fax

Practice location:
  • Phone: 210-201-4327
  • Fax: 949-437-2183
Mailing address:
  • Phone: 210-201-4327
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE M VACIANNA
Title or Position: FAMILY NURSE PRACTITIONER/OWNER
Credential: FNP-C
Phone: 210-201-4327