1154768703 NPI number — MS. CANDYCE ANN YUKIE KAAIAI LCSW

Table of content: MS. CANDYCE ANN YUKIE KAAIAI LCSW (NPI 1154768703)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154768703 NPI number — MS. CANDYCE ANN YUKIE KAAIAI LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KAAIAI
Provider First Name:
CANDYCE
Provider Middle Name:
ANN YUKIE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1154768703
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/21/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 182
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KAAAWA
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96730
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-358-8336
Provider Business Mailing Address Fax Number:
808-432-8213

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1319 PUNAHOU STREET
Provider Second Line Business Practice Location Address:
SUITE 950
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96826
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-983-6100
Provider Business Practice Location Address Fax Number:
808-983-6105
Provider Enumeration Date:
05/22/2013

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: 1041C0700X , with the licence number:  3846 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , 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)





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