Provider Demographics
NPI:1700264439
Name:TANI, SHAROLYN SHT (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SHAROLYN
Middle Name:SHT
Last Name:TANI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:SHAROLYN
Other - Middle Name:SH
Other - Last Name:TAMASHIRO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:PO BOX 3378
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96801-3378
Mailing Address - Country:US
Mailing Address - Phone:808-586-4687
Mailing Address - Fax:
Practice Address - Street 1:860 4TH ST
Practice Address - Street 2:
Practice Address - City:PEARL CITY
Practice Address - State:HI
Practice Address - Zip Code:96782-3690
Practice Address - Country:US
Practice Address - Phone:808-453-5953
Practice Address - Fax:808-453-5966
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-14
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1516103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist