1053532473 NPI number — SHIRLEY ANN OAKES CSW

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053532473 NPI number — SHIRLEY ANN OAKES CSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OAKES
Provider First Name:
SHIRLEY
Provider Middle Name:
ANN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
OAKES
Provider Other First Name:
SHIRLEY
Provider Other Middle Name:
C
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
CSW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1053532473
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/13/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1379 MOANALUALANI PL APT B
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HONOLULU
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96819-1237
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-255-6482
Provider Business Mailing Address Fax Number:
808-836-3082

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
460 ENA RD
Provider Second Line Business Practice Location Address:
SUITE 505
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96815-1779
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-255-6482
Provider Business Practice Location Address Fax Number:
808-836-3082
Provider Enumeration Date:
05/01/2007

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: 1041C0700X , with the licence number:  LCSW-3169 , 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)

  • Identifier: 00B0220265 . This is a "HMSA" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 00B0220265 . This is a "HMSA QUEST" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 571221345 . This is a "ALOHACARE" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 00B0220265 . This is a "TRICARE" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 499328 , issued by the state of ( HI ) . This identifiers is of the category "MEDICAID".




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