Provider Demographics
NPI:1497410021
Name:SAPADEN, DONNA DOMINGO
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:DOMINGO
Last Name:SAPADEN
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 1:86-140 LEIHOKU ST
Mailing Address - Street 2:
Mailing Address - City:WAIANAE
Mailing Address - State:HI
Mailing Address - Zip Code:96792-2985
Mailing Address - Country:US
Mailing Address - Phone:808-439-9877
Mailing Address - Fax:808-696-5002
Practice Address - Street 1:86-140 LEIHOKU ST
Practice Address - Street 2:
Practice Address - City:WAIANAE
Practice Address - State:HI
Practice Address - Zip Code:96792-2985
Practice Address - Country:US
Practice Address - Phone:808-439-9877
Practice Address - Fax:808-696-5002
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-08
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide