Provider Demographics
NPI:1164030193
Name:SAGAPOLUTELE, CHARLENE JOYCE BATOON
Entity Type:Individual
Prefix:
First Name:CHARLENE JOYCE
Middle Name:BATOON
Last Name:SAGAPOLUTELE
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 1:46-078 EMEPELA PL APT K104
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-3962
Mailing Address - Country:US
Mailing Address - Phone:817-255-0343
Mailing Address - Fax:
Practice Address - Street 1:2848 PARK ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-1157
Practice Address - Country:US
Practice Address - Phone:808-595-0111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-15
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker