Provider Demographics
NPI:1679647739
Name:SAMPAYAN, ANNA LIZA ABANIEL (PT)
Entity Type:Individual
Prefix:MS
First Name:ANNA LIZA
Middle Name:ABANIEL
Last Name:SAMPAYAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:ANNA LIZA
Other - Middle Name:
Other - Last Name:LOPEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:3778 KALIHI STREET
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819
Mailing Address - Country:US
Mailing Address - Phone:808-388-2690
Mailing Address - Fax:
Practice Address - Street 1:1350 S KING ST STE 307
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-2008
Practice Address - Country:US
Practice Address - Phone:808-809-8057
Practice Address - Fax:808-582-7755
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019555-1225100000X
HI3780225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist