Provider Demographics
NPI:1225735608
Name:CHATTIN, KAYLIANA ROSE (BA)
Entity Type:Individual
Prefix:
First Name:KAYLIANA
Middle Name:ROSE
Last Name:CHATTIN
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:KAYLIANA
Other - Middle Name:ROSE
Other - Last Name:LANZARO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:710 GREEN ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2119
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:710 GREEN ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2119
Practice Address - Country:US
Practice Address - Phone:808-940-6437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-15
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator