Provider Demographics
NPI:1588002174
Name:UYEDA, TANYA JINA (LMFT, CSAC)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:JINA
Last Name:UYEDA
Suffix:
Gender:F
Credentials:LMFT, CSAC
Other - Prefix:
Other - First Name:JINA
Other - Middle Name:TANYA
Other - Last Name:UYEDA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT, CSAC
Mailing Address - Street 1:94-101 LULUKA PL APT K203
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-5138
Mailing Address - Country:US
Mailing Address - Phone:808-351-9511
Mailing Address - Fax:
Practice Address - Street 1:970 N KALAHEO AVE
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-1866
Practice Address - Country:US
Practice Address - Phone:808-351-9511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMFT513106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist