Provider Demographics
NPI:1205333846
Name:TATEISHI, JANE CHA (PT, DPT)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:CHA
Last Name:TATEISHI
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94-801 FARRINGTON HWY STE W2
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-3149
Mailing Address - Country:US
Mailing Address - Phone:808-680-9123
Mailing Address - Fax:
Practice Address - Street 1:94-801 FARRINGTON HWY STE W2
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-3149
Practice Address - Country:US
Practice Address - Phone:808-680-9123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-10
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT4774225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist