Provider Demographics
NPI:1063237519
Name:AMOGUIS, TRISHA BALIQUATRO
Entity type:Individual
Prefix:
First Name:TRISHA
Middle Name:BALIQUATRO
Last Name:AMOGUIS
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 1:4275 HALUPA ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96818-1818
Mailing Address - Country:US
Mailing Address - Phone:808-773-5612
Mailing Address - Fax:
Practice Address - Street 1:4275 HALUPA ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96818-1818
Practice Address - Country:US
Practice Address - Phone:808-773-5612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-20
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician