=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184581597
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANGELA CHRONIS WATSON
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/07/2026
-----------------------------------------------------
Last Update Date | 01/07/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4590 HANA HWY
-----------------------------------------------------
City | HANA
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96713
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-248-8294
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 992
-----------------------------------------------------
City | HANA
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96713-0992
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-856-6008
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | MHC-1188-0
-----------------------------------------------------
License Number State | HI
-----------------------------------------------------