Provider Demographics
NPI:1831723071
Name:HAYASAKA, RUBY ANN (RDN)
Entity type:Individual
Prefix:
First Name:RUBY
Middle Name:ANN
Last Name:HAYASAKA
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41-1694 KALANIANAOLE HWY
Mailing Address - Street 2:
Mailing Address - City:WAIMANALO
Mailing Address - State:HI
Mailing Address - Zip Code:96795-1142
Mailing Address - Country:US
Mailing Address - Phone:808-220-1215
Mailing Address - Fax:
Practice Address - Street 1:1357 KAPIOLANI BLVD STE 1460
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-4509
Practice Address - Country:US
Practice Address - Phone:808-942-1852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-26
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered