| Tracy M Taniguchi Psy D Llc | |
|
688 Kinoole St Suite # 206 Hilo HI 96720-3877 | |
| (808) 227-7682 | |
| (877) 795-7918 |
| Full Name | Tracy M Taniguchi Psy D Llc |
|---|---|
| Speciality | Psychologist |
| Location | 688 Kinoole St, Hilo, Hawaii |
| Authorized Official Name and Position | Tracy M.t. Yamasaki (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 8082277682 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tracy M Taniguchi Psy D Llc 688 Kinoole St Suite # 206 Hilo HI 96720-3877 Ph: (808) 227-7682 | Tracy M Taniguchi Psy D Llc 688 Kinoole St Suite # 206 Hilo HI 96720-3877 Ph: (808) 227-7682 |
| NPI Number | 1457724031 |
|---|---|
| Provider Enumeration Date | 11/04/2015 |
| Last Update Date | 12/01/2022 |
| Certification Date | 12/01/2022 |
| Medicare PECOS PAC ID | 4688975907 |
|---|---|
| Medicare Enrollment ID | O20151210001647 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457724031 | NPI | - | NPPES |
| 1013275205 | Other | HI | NPI TYPE 1 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 1320 (Hawaii) | Primary |
| Provider Name | Tracy Mt Yamasaki |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1013275205 PECOS PAC ID: 5597066811 Enrollment ID: I20151210002290 |
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