1588002174 NPI number — TANYA JINA UYEDA LMFT, CSAC

Table of content: TANYA JINA UYEDA LMFT, CSAC (NPI 1588002174)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588002174 NPI number — TANYA JINA UYEDA LMFT, CSAC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
UYEDA
Provider First Name:
TANYA
Provider Middle Name:
JINA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LMFT, CSAC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
UYEDA
Provider Other First Name:
JINA
Provider Other Middle Name:
TANYA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LMFT, CSAC
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1588002174
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
94-101 LULUKA PL APT K203
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WAIPAHU
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96797-5138
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-351-9511
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
970 N KALAHEO AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KAILUA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96734-1866
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-351-9511
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/05/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  MFT513 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)