Provider Demographics
NPI:1457088759
Name:KEALOHA MEYER, TATIANA
Entity type:Individual
Prefix:
First Name:TATIANA
Middle Name:
Last Name:KEALOHA MEYER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:TATIANA
Other - Middle Name:
Other - Last Name:DE LA CRUZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:87-151 LILIANA ST
Mailing Address - Street 2:
Mailing Address - City:WAIANAE
Mailing Address - State:HI
Mailing Address - Zip Code:96792-3143
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:86-888 FARRINGTON HIGHWAY
Practice Address - Street 2:
Practice Address - City:WAIANAE
Practice Address - State:HI
Practice Address - Zip Code:96792
Practice Address - Country:US
Practice Address - Phone:808-696-9498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-05
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health