Provider Demographics
NPI:1518196609
Name:RACE, VANESSA RENEE
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:RENEE
Last Name:RACE
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 1:45-557 KEAAHALA RD
Mailing Address - Street 2:#G
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-3338
Mailing Address - Country:US
Mailing Address - Phone:808-782-5301
Mailing Address - Fax:
Practice Address - Street 1:1100 ALAKEA ST
Practice Address - Street 2:9TH FLOOR
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2833
Practice Address - Country:US
Practice Address - Phone:808-523-7771
Practice Address - Fax:808-523-1997
Is Sole Proprietor?:No
Enumeration Date:2009-07-09
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health