Provider Demographics
NPI:1275216368
Name:MENCIAS, PLACIDA CALIBOSO (FAMILY CAREGIVER)
Entity Type:Individual
Prefix:MRS
First Name:PLACIDA
Middle Name:CALIBOSO
Last Name:MENCIAS
Suffix:
Gender:F
Credentials:FAMILY CAREGIVER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94-1128 KAHUAILANI ST
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-3601
Mailing Address - Country:US
Mailing Address - Phone:808-692-6520
Mailing Address - Fax:
Practice Address - Street 1:94-1128 KAHUAILANI ST
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-3601
Practice Address - Country:US
Practice Address - Phone:808-692-6520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-08
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide