Provider Demographics
NPI:1205419694
Name:BIACAN, DARRELL (CNA)
Entity Type:Individual
Prefix:
First Name:DARRELL
Middle Name:
Last Name:BIACAN
Suffix:
Gender:M
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94-610 HIAHIA PL
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-3815
Mailing Address - Country:US
Mailing Address - Phone:808-465-5952
Mailing Address - Fax:
Practice Address - Street 1:94-610 HIAHIA PL
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-3815
Practice Address - Country:US
Practice Address - Phone:808-465-5952
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-03
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home