Provider Demographics
NPI:1215631486
Name:BAUTISTA, SHARI ANN HARUMI (LCSW)
Entity type:Individual
Prefix:
First Name:SHARI ANN
Middle Name:HARUMI
Last Name:BAUTISTA
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 HALONA ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-2796
Mailing Address - Country:US
Mailing Address - Phone:808-843-5312
Mailing Address - Fax:
Practice Address - Street 1:1300 HALONA ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-2796
Practice Address - Country:US
Practice Address - Phone:808-843-5312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-29
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILCSW-50381041C0700X
HILSW-2565104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker