Provider Demographics
NPI:1922863141
Name:RABANES, CLARIZA
Entity Type:Individual
Prefix:
First Name:CLARIZA
Middle Name:
Last Name:RABANES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 ANI ST
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732-2761
Mailing Address - Country:US
Mailing Address - Phone:808-463-7679
Mailing Address - Fax:
Practice Address - Street 1:360 HOOHANA ST STE A101
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-2975
Practice Address - Country:US
Practice Address - Phone:808-463-7679
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-16
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI181-HCA374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty