Provider Demographics
NPI:1093194656
Name:ANAYA, LINDA ESTREYA
Entity Type:Individual
Prefix:MISS
First Name:LINDA
Middle Name:ESTREYA
Last Name:ANAYA
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 1:75-5995 KUAKINI HWY STE 221
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-2120
Mailing Address - Country:US
Mailing Address - Phone:808-940-6810
Mailing Address - Fax:808-465-3005
Practice Address - Street 1:75-5995 KUAKINI HWY STE 221
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-2120
Practice Address - Country:US
Practice Address - Phone:808-940-6810
Practice Address - Fax:808-465-3005
Is Sole Proprietor?:No
Enumeration Date:2015-05-28
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL390200000X
HIMHC-705101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program