Provider Demographics
NPI:1588740484
Name:TASUHARA, JUNE TAKAKO (PSYD)
Entity type:Individual
Prefix:DR
First Name:JUNE
Middle Name:TAKAKO
Last Name:TASUHARA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:MS
Other - First Name:JUNE
Other - Middle Name:TAKAKO
Other - Last Name:SAKIMOTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:98 1247 KAAHUMANU ST
Mailing Address - Street 2:SUITE 223
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701
Mailing Address - Country:US
Mailing Address - Phone:808-487-5433
Mailing Address - Fax:808-487-5444
Practice Address - Street 1:98 1247 KAAHUMANU ST
Practice Address - Street 2:SUITE 223
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701
Practice Address - Country:US
Practice Address - Phone:808-487-5433
Practice Address - Fax:808-487-5444
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY907103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI256230OtherHMSA