Provider Demographics
NPI:1336661727
Name:WOOD, PAMELA CASTALDO (BCBA 1-17-28098)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:CASTALDO
Last Name:WOOD
Suffix:
Gender:F
Credentials:BCBA 1-17-28098
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4510 SALT LAKE BLVD STE D8
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96818-3172
Mailing Address - Country:US
Mailing Address - Phone:808-486-1804
Mailing Address - Fax:
Practice Address - Street 1:4510 SALT LAKE BLVD
Practice Address - Street 2:D-8
Practice Address - City:HONLULU
Practice Address - State:HI
Practice Address - Zip Code:96818
Practice Address - Country:US
Practice Address - Phone:808-486-1804
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI1942689526Medicaid