Provider Demographics
NPI:1194211086
Name:UYENO, KACY AKIKO (MS, ATC)
Entity Type:Individual
Prefix:
First Name:KACY
Middle Name:AKIKO
Last Name:UYENO
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 S BERETANIA ST STE 700
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1874
Mailing Address - Country:US
Mailing Address - Phone:808-691-4211
Mailing Address - Fax:
Practice Address - Street 1:1401 S BERETANIA ST STE 700
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1874
Practice Address - Country:US
Practice Address - Phone:808-691-4211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-03
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAT-3422255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer