Provider Demographics
NPI:1306989991
Name:RODRIGUES, NOELANI C (PHD)
Entity type:Individual
Prefix:DR
First Name:NOELANI
Middle Name:C
Last Name:RODRIGUES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:MARIE
Other - Last Name:GALIANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:590 FARRINGTON HWY.
Mailing Address - Street 2:SUITE 210-118
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707
Mailing Address - Country:US
Mailing Address - Phone:808-938-9971
Mailing Address - Fax:
Practice Address - Street 1:511 MANAWAI STREET
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707
Practice Address - Country:US
Practice Address - Phone:808-938-9971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKMFT-274106H00000X
COMFT-0001143106H00000X
HIMFT-155106H00000X
CAMFT-88853106H00000X
HI171M00000X
HIPSY-1777103TC0700X
HI155106H00000X
CA42606106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI539372-18Medicaid