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NPI Code Detail

MEDICARE: ANTONIO T ANAGARAN JR. MA, MFA

MEDICARE: ANTONIO T ANAGARAN JR. MA, MFA
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1578383162
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTONIO T ANAGARAN JR. MA, MFA
Provider Business Mailing Address
First Line : 5211 HAO PL
Second Line :
City : HONOLULU
State : HI
Zip : 96821-1627
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2444 DOLE ST
Second Line :
City : HONOLULU
State : HI
Zip : 96822-2399
Country : US
Telephone Number : 808-956-9559
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/16/2024
Last Update Date : 10/16/2024

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