Provider Demographics
NPI:1659692523
Name:NAKATA, CHANTELLE F L S (AUD)
Entity Type:Individual
Prefix:
First Name:CHANTELLE
Middle Name:F L S
Last Name:NAKATA
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:CHANTELLE
Other - Middle Name:F L
Other - Last Name:SHIU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1010 PENSACOLA ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-2118
Mailing Address - Country:US
Mailing Address - Phone:808-432-2000
Mailing Address - Fax:
Practice Address - Street 1:1010 PENSACOLA ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-2118
Practice Address - Country:US
Practice Address - Phone:808-432-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-15
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAUD-118231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist