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General NPI Number Information
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NPI Number | 1326890708
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Entity Type | Organization
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Legal Business Name | KRISTI TANAKA LLC
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Dates
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Enumeration Date | 04/01/2024
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Last Update Date | 04/01/2024
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Provider Practice Location Address
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Address Line | 45-270 WILLIAM HENRY RD STE 207
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City | KANEOHE
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State | HI
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Zip | 96744-5808
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Country | US
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Telephone | 808-379-3031
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Fax |
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Provider Business Mailing Address
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Address Line | 21739 HARDY OAK BLVD APT 6307
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City | SAN ANTONIO
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State | TX
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Zip | 78258-2381
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Country | US
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Telephone | 808-220-8044
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KRISTI TANAKA
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Credential | PSYD, LCSW
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Telephone | 808-374-0094
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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