Provider Demographics
NPI:1083166482
Name:ALETHEA, SARAH WAYAN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:WAYAN
Last Name:ALETHEA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41-976 LAUMILO ST
Mailing Address - Street 2:
Mailing Address - City:WAIMANALO
Mailing Address - State:HI
Mailing Address - Zip Code:96795-1661
Mailing Address - Country:US
Mailing Address - Phone:808-428-0312
Mailing Address - Fax:808-259-9169
Practice Address - Street 1:41-976 LAUMILO ST
Practice Address - Street 2:
Practice Address - City:WAIMANALO
Practice Address - State:HI
Practice Address - Zip Code:96795-1661
Practice Address - Country:US
Practice Address - Phone:808-428-0312
Practice Address - Fax:808-259-9169
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-01
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1618103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical