Provider Demographics
NPI:1194583005
Name:BASCAR, KRYSTIANNA KAHEANALEOLANI EMIKO
Entity type:Individual
Prefix:MRS
First Name:KRYSTIANNA
Middle Name:KAHEANALEOLANI EMIKO
Last Name:BASCAR
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 ALA MAKANI ST STE 200
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732-3571
Mailing Address - Country:US
Mailing Address - Phone:808-204-2893
Mailing Address - Fax:
Practice Address - Street 1:427 ALA MAKANI ST STE 200
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-3571
Practice Address - Country:US
Practice Address - Phone:808-204-2893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-06
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician