Provider Demographics
NPI:1073916177
Name:KALAMA, TRISTYN (MSCP, CSAC, ICADC)
Entity Type:Individual
Prefix:
First Name:TRISTYN
Middle Name:
Last Name:KALAMA
Suffix:
Gender:F
Credentials:MSCP, CSAC, ICADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 29819
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96820-2219
Mailing Address - Country:US
Mailing Address - Phone:808-847-4227
Mailing Address - Fax:808-842-0044
Practice Address - Street 1:1130 N NIMITZ HWY RM A226
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-5781
Practice Address - Country:US
Practice Address - Phone:808-847-4227
Practice Address - Fax:808-842-0044
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-02
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HICL1330101Y00000X
HI1723-13101Y00000X, 101YM0800X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health