Provider Demographics
NPI:1336032184
Name:VALERA, JAILANIE CANONIZADO
Entity type:Individual
Prefix:
First Name:JAILANIE
Middle Name:CANONIZADO
Last Name:VALERA
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 1:38 WAILANI ST
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-1818
Mailing Address - Country:US
Mailing Address - Phone:808-276-1965
Mailing Address - Fax:
Practice Address - Street 1:3079 MANU HOPE PL
Practice Address - Street 2:
Practice Address - City:WAILEA
Practice Address - State:HI
Practice Address - Zip Code:96753-7712
Practice Address - Country:US
Practice Address - Phone:808-276-1965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRN-116437374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide