Provider Demographics
NPI:1346328838
Name:SCHMIDT, DONNA C
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:C
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1245 KUALA ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PEARL CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96782-3900
Mailing Address - Country:US
Mailing Address - Phone:808-456-2273
Mailing Address - Fax:808-456-2274
Practice Address - Street 1:1245 KUALA ST
Practice Address - Street 2:SUITE 103
Practice Address - City:PEARL CITY
Practice Address - State:HI
Practice Address - Zip Code:96782-3900
Practice Address - Country:US
Practice Address - Phone:808-456-2273
Practice Address - Fax:808-456-2274
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILCSW 30631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI21216-7OtherHMSA PRIVATE INSURANCE
HICH203BMedicare PIN