Provider Demographics
NPI:1558418772
Name:YOSHIMURA, SHERYL RANESES (RD)
Entity Type:Individual
Prefix:MS
First Name:SHERYL
Middle Name:RANESES
Last Name:YOSHIMURA
Suffix:
Gender:F
Credentials:RD
Other - Prefix:MS
Other - First Name:SHERYL
Other - Middle Name:MARIANO
Other - Last Name:RANESES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:2239 N SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-2539
Mailing Address - Country:US
Mailing Address - Phone:808-791-9400
Mailing Address - Fax:808-848-0979
Practice Address - Street 1:2239 N SCHOOL ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-2539
Practice Address - Country:US
Practice Address - Phone:808-791-9400
Practice Address - Fax:808-848-0979
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI865562133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000247882OtherHMSA
HI00992101Medicaid
HI00992101Medicaid