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NPI 1255287744

NPI 1255287744 : DR. MAYA MATHEIS, LLC (DBA: MANGO TREE CENTER) : HONOLULU, HI

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General NPI Number Information
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    NPI Number           |    1255287744
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    Entity Type          |    Organization 
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    Legal Business Name  |    DR. MAYA MATHEIS, LLC (DBA: MANGO TREE CENTER) 
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Dates
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    Enumeration Date     |    03/06/2026
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    Last Update Date     |    03/06/2026
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Provider Practice Location Address
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    Address Line         |    1164 BISHOP ST STE 929 
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    City                 |    HONOLULU
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    State                |    HI
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    Zip                  |    96813-2882
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    Country              |    US
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    Telephone            |    808-556-7708
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    Fax                  |    808-204-1068
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Provider Business Mailing Address
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    Address Line         |    1164 BISHOP ST STE 929 
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    City                 |    HONOLULU
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    State                |    HI
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    Zip                  |    96813-2882
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    Country              |    US
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    Telephone            |    808-556-7708
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    Fax                  |    808-204-1068
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Authorized Official
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    Title or Position    |    DIRECTOR
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    Name                 |    DR. MAYA NATASSIA MATHEIS 
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    Credential           |    PHD
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    Telephone            |    808-556-7708
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    103K00000X
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    Taxonomy Name        |    Behavior Analyst
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    103TC0700X
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    Taxonomy Name        |    Clinical Psychologist
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    License Number       |    
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    License Number State |    
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