Provider Demographics
NPI:1932743630
Name:ANAMA, FATIMA
Entity type:Individual
Prefix:
First Name:FATIMA
Middle Name:
Last Name:ANAMA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94-209 LOKU PL
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-5505
Mailing Address - Country:US
Mailing Address - Phone:808-226-2830
Mailing Address - Fax:
Practice Address - Street 1:94-209 LOKU PL
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-5505
Practice Address - Country:US
Practice Address - Phone:808-226-2830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-05
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician