Provider Demographics
NPI:1063909281
Name:OBAYASHI, TIFFANI SAKIKO MAHINA
Entity type:Individual
Prefix:MS
First Name:TIFFANI
Middle Name:SAKIKO MAHINA
Last Name:OBAYASHI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67-383 KUKEA CIR
Mailing Address - Street 2:
Mailing Address - City:WAIALUA
Mailing Address - State:HI
Mailing Address - Zip Code:96791-9520
Mailing Address - Country:US
Mailing Address - Phone:808-520-7183
Mailing Address - Fax:
Practice Address - Street 1:67-383 KUKEA CIR
Practice Address - Street 2:
Practice Address - City:WAIALUA
Practice Address - State:HI
Practice Address - Zip Code:96791-9520
Practice Address - Country:US
Practice Address - Phone:808-520-7183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-13
Last Update Date:2018-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician