=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457163867
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANGELINA DINGLE CABUSAS PMHNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/22/2025
-----------------------------------------------------
Last Update Date | 01/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 806 IWILEI RD
-----------------------------------------------------
City | HONOLULU
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96817-5016
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-556-2951
-----------------------------------------------------
Fax | 808-650-2958
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1021 6TH AVE APT A
-----------------------------------------------------
City | HONOLULU
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96816-1649
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-497-4311
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | APRN-5007
-----------------------------------------------------
License Number State | HI
-----------------------------------------------------