Provider Demographics
NPI:1114402237
Name:TUNGUL, CLAUDINE IONA
Entity type:Individual
Prefix:
First Name:CLAUDINE
Middle Name:IONA
Last Name:TUNGUL
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 1:3838 GALACTICA DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99517-1587
Mailing Address - Country:US
Mailing Address - Phone:907-726-7076
Mailing Address - Fax:
Practice Address - Street 1:98-1380 HINU PL APT C
Practice Address - Street 2:
Practice Address - City:PEARL CITY
Practice Address - State:HI
Practice Address - Zip Code:96782-3002
Practice Address - Country:US
Practice Address - Phone:907-726-7076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-25
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK106S00000X
HIBA-864-0103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician