Provider Demographics
NPI:1255706081
Name:KAAHANUI, SHERRI ANN K (PSYD, CSAC)
Entity type:Individual
Prefix:
First Name:SHERRI ANN
Middle Name:K
Last Name:KAAHANUI
Suffix:
Gender:F
Credentials:PSYD, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1109 12TH AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-3714
Mailing Address - Country:US
Mailing Address - Phone:808-927-8746
Mailing Address - Fax:808-466-8313
Practice Address - Street 1:1109 12TH AVE STE 201
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-3714
Practice Address - Country:US
Practice Address - Phone:808-927-8746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-04
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1552103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI797053Medicaid
HIPSY-1552OtherLICENSE NUMBER