Provider Demographics
NPI:1033350251
Name:TANAKA, KRISTI K (LCSW, DCSW, BCD)
Entity Type:Individual
Prefix:MS
First Name:KRISTI
Middle Name:K
Last Name:TANAKA
Suffix:
Gender:F
Credentials:LCSW, DCSW, BCD
Other - Prefix:MRS
Other - First Name:KRISTI
Other - Middle Name:KT
Other - Last Name:ALMEIDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW, QCSW
Mailing Address - Street 1:3478 SALT LAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96818-2124
Mailing Address - Country:US
Mailing Address - Phone:808-755-9370
Mailing Address - Fax:808-442-1204
Practice Address - Street 1:540 OAK CENTRE DR STE 205
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4767
Practice Address - Country:US
Practice Address - Phone:844-824-8775
Practice Address - Fax:281-648-2200
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-18
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI35551041C0700X
TX1112531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
BCD-58629OtherAMERICAN BOARD OF EXAMINERS IN CLINICAL SOCIAL WORK