Provider Demographics
NPI:1932991130
Name:JAVIER, MARY GRACE CABBAB
Entity type:Individual
Prefix:MRS
First Name:MARY GRACE
Middle Name:CABBAB
Last Name:JAVIER
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94-1257 KAHUAINA ST
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-3408
Mailing Address - Country:US
Mailing Address - Phone:808-348-1318
Mailing Address - Fax:808-490-0549
Practice Address - Street 1:94-1257 KAHUAINA ST
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-3408
Practice Address - Country:US
Practice Address - Phone:808-348-1318
Practice Address - Fax:808-490-0549
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-22
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIHICA0019647E376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide