Provider Demographics
NPI:1417137720
Name:ZENG, RAINBOW
Entity Type:Individual
Prefix:
First Name:RAINBOW
Middle Name:
Last Name:ZENG
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:PO BOX 1656
Mailing Address - Street 2:
Mailing Address - City:KEAAU
Mailing Address - State:HI
Mailing Address - Zip Code:96749-1656
Mailing Address - Country:US
Mailing Address - Phone:425-443-2598
Mailing Address - Fax:
Practice Address - Street 1:15-1890 7TH AVE
Practice Address - Street 2:
Practice Address - City:KEAAU
Practice Address - State:HI
Practice Address - Zip Code:96749-9674
Practice Address - Country:US
Practice Address - Phone:425-443-2598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-05
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60894244101YM0800X
HIMHC-596101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WARC00050052OtherSTATE LICENSE