Provider Demographics
NPI:1851600639
Name:GAMBOA, ARLENE DE GUZMAN (CNA)
Entity Type:Individual
Prefix:MRS
First Name:ARLENE
Middle Name:DE GUZMAN
Last Name:GAMBOA
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 UHU ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-4150
Mailing Address - Country:US
Mailing Address - Phone:808-744-3005
Mailing Address - Fax:808-744-3005
Practice Address - Street 1:2001 UHU ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-4150
Practice Address - Country:US
Practice Address - Phone:808-744-3005
Practice Address - Fax:808-744-3005
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-28
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIHIO20412094376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide