Provider Demographics
NPI:1912498924
Name:CISTERNAS, SHARON BIBI (LCSW)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:BIBI
Last Name:CISTERNAS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:
Other - Last Name:BIBI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:963 HONOKAHUA PL
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96825-3032
Mailing Address - Country:US
Mailing Address - Phone:808-673-6284
Mailing Address - Fax:808-394-2826
Practice Address - Street 1:963 HONOKAHUA PL
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96825-3032
Practice Address - Country:US
Practice Address - Phone:808-673-6284
Practice Address - Fax:808-394-2826
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-24
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI101YA0400X
HI39381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)