Provider Demographics
NPI:1477703205
Name:TATEYAMA, DAVID
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:TATEYAMA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98-1238 KAAHUMANU ST STE 403
Mailing Address - Street 2:
Mailing Address - City:PEARL CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96782-3292
Mailing Address - Country:US
Mailing Address - Phone:808-448-1996
Mailing Address - Fax:
Practice Address - Street 1:98-1238 KAAHUMANU ST STE 403
Practice Address - Street 2:
Practice Address - City:PEARL CITY
Practice Address - State:HI
Practice Address - Zip Code:96782-3292
Practice Address - Country:US
Practice Address - Phone:808-448-1996
Practice Address - Fax:808-486-1997
Is Sole Proprietor?:No
Enumeration Date:2008-09-29
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health