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NPI Code Detail

MEDICARE: MS. KRISTI K TANAKA LCSW, DCSW, BCD

MEDICARE:  MS. KRISTI K TANAKA  LCSW, DCSW, BCD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker3555HI
21041C0700XClinical Social Worker111253TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1BCD-58629OTHERAMERICAN BOARD OF EXAMINERS IN CLINICAL SOCIAL WORK

General Provider Information

NPI Number : 1033350251
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KRISTI K TANAKA LCSW, DCSW, BCD
Provider Business Mailing Address
First Line : 3478 SALT LAKE BLVD
Second Line :
City : HONOLULU
State : HI
Zip : 96818-2124
Country : US
Telephone Number : 808-755-9370
Fax Number : 808-442-1204
Provider Business Practice Location Address
First Line : 540 OAK CENTRE DR STE 205
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78258-4767
Country : US
Telephone Number : 844-824-8775
Fax Number : 281-648-2200
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2009
Last Update Date : 11/17/2023

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Directions to “ MS. KRISTI K TANAKA LCSW, DCSW, BCD” Practice Location

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