Provider Demographics
NPI:1891864542
Name:UEDA, SUBIN (MSW)
Entity Type:Individual
Prefix:
First Name:SUBIN
Middle Name:
Last Name:UEDA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3375 KOAPAKA ST STE F22014
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-1816
Mailing Address - Country:US
Mailing Address - Phone:808-538-2538
Mailing Address - Fax:
Practice Address - Street 1:3375 KOAPAKA ST STE F22014
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-1816
Practice Address - Country:US
Practice Address - Phone:808-538-2538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW 168661041C0700X
HILCSW37891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical