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NPI Code Detail

MEDICARE: SHARI ANN HARUMI BAUTISTA LCSW

MEDICARE: SHARI ANN HARUMI BAUTISTA LCSW
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 WorkerLCSW-5038HI
2104100000XSocial WorkerLSW-2565HI

General Provider Information

NPI Number : 1215631486
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHARI ANN HARUMI BAUTISTA LCSW
Provider Business Mailing Address
First Line : 1300 HALONA ST
Second Line :
City : HONOLULU
State : HI
Zip : 96817-2796
Country : US
Telephone Number : 808-843-5312
Fax Number :
Provider Business Practice Location Address
First Line : 1300 HALONA ST
Second Line :
City : HONOLULU
State : HI
Zip : 96817-2796
Country : US
Telephone Number : 808-843-5312
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2023
Last Update Date : 03/05/2025

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