Provider Demographics
NPI:1598109241
Name:DANZ, TRISA MARIE (MD)
Entity Type:Individual
Prefix:
First Name:TRISA
Middle Name:MARIE
Last Name:DANZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1314 S KING ST STE 1255
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1947
Mailing Address - Country:US
Mailing Address - Phone:808-744-2002
Mailing Address - Fax:737-221-5808
Practice Address - Street 1:1314 S KING ST STE 1255
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1947
Practice Address - Country:US
Practice Address - Phone:808-798-8781
Practice Address - Fax:737-221-5808
Is Sole Proprietor?:No
Enumeration Date:2013-04-24
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-190692084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry