Provider Demographics
NPI:1457077026
Name:GUITERAS, KALIA
Entity Type:Individual
Prefix:
First Name:KALIA
Middle Name:
Last Name:GUITERAS
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 1:40 KUPUOHI ST
Mailing Address - Street 2:
Mailing Address - City:LAHAINA
Mailing Address - State:HI
Mailing Address - Zip Code:96761-2701
Mailing Address - Country:US
Mailing Address - Phone:808-446-4561
Mailing Address - Fax:855-940-3108
Practice Address - Street 1:40 KUPUOHI ST
Practice Address - Street 2:
Practice Address - City:LAHAINA
Practice Address - State:HI
Practice Address - Zip Code:96761-2701
Practice Address - Country:US
Practice Address - Phone:808-446-4561
Practice Address - Fax:855-940-3108
Is Sole Proprietor?:No
Enumeration Date:2022-10-17
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
HI106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician