Provider Demographics
NPI:1013621747
Name:PASCUAL, TEOFILA JOAN (CNA)
Entity Type:Individual
Prefix:
First Name:TEOFILA JOAN
Middle Name:
Last Name:PASCUAL
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 1:98-202 KANUKU ST
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-5215
Mailing Address - Country:US
Mailing Address - Phone:808-597-7879
Mailing Address - Fax:808-379-0580
Practice Address - Street 1:98-202 KANUKU ST
Practice Address - Street 2:
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-5215
Practice Address - Country:US
Practice Address - Phone:808-597-7879
Practice Address - Fax:808-379-0580
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIHI000005708376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide