Provider Demographics
NPI:1437886454
Name:SAGARIO, CHRYSTALLINE JOY
Entity Type:Individual
Prefix:
First Name:CHRYSTALLINE
Middle Name:JOY
Last Name:SAGARIO
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 1:99-040 KAUHALE ST UNIT 2234
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-7291
Mailing Address - Country:US
Mailing Address - Phone:808-351-0706
Mailing Address - Fax:
Practice Address - Street 1:98-450 KOAUKA LOOP APT 1102
Practice Address - Street 2:
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-4528
Practice Address - Country:US
Practice Address - Phone:808-351-0706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-01
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMHC-457101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health