Provider Demographics
NPI:1972508679
Name:NAVARRO, RICHARD M (PHD/CCC/A)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:M
Last Name:NAVARRO
Suffix:
Gender:M
Credentials:PHD/CCC/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 HANA HWY STE K
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732-2315
Mailing Address - Country:US
Mailing Address - Phone:808-871-9020
Mailing Address - Fax:808-871-9024
Practice Address - Street 1:444 HANA HWY STE K
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732
Practice Address - Country:US
Practice Address - Phone:808-871-9020
Practice Address - Fax:808-871-9024
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51191231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX112795304Medicaid
TX112795303Medicaid
TX112795302Medicaid