Provider Demographics
NPI:1386963189
Name:HALONA TANNER LLC
Entity type:Organization
Organization Name:HALONA TANNER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HALONA
Authorized Official - Middle Name:W
Authorized Official - Last Name:TANNER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:808-282-1081
Mailing Address - Street 1:46-005 KAWA ST
Mailing Address - Street 2:SUITE 304
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-3805
Mailing Address - Country:US
Mailing Address - Phone:808-282-1081
Mailing Address - Fax:808-239-9493
Practice Address - Street 1:46-005 KAWA ST
Practice Address - Street 2:SUITE 304
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-3805
Practice Address - Country:US
Practice Address - Phone:808-282-1081
Practice Address - Fax:808-239-9493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-19
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY-1020261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)