Individual
DR. TANYA J. D'AVANZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
345 QUEEN ST STE 703, HONOLULU, HI 96813-4718
(808) 521-3761
(800) 491-4155
Mailing address
1123 KOOHOO PL, KAILUA, HI 96734-3276
(808) 566-3761
(808) 566-3859
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
PSY635
HI
103TC0700X
Clinical Psychologist
Primary
PSY635
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08930801
—
HI
01
—
22363
HMSA
HI
Enumeration date
10/17/2006
Last updated
02/01/2019
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