Provider Demographics
NPI:1053532473
Name:OAKES, SHIRLEY ANN (CSW)
Entity type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:ANN
Last Name:OAKES
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:SHIRLEY
Other - Middle Name:C
Other - Last Name:OAKES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CSW
Mailing Address - Street 1:1379 MOANALUALANI PL APT B
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-1237
Mailing Address - Country:US
Mailing Address - Phone:808-255-6482
Mailing Address - Fax:808-836-3082
Practice Address - Street 1:460 ENA RD
Practice Address - Street 2:SUITE 505
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815-1779
Practice Address - Country:US
Practice Address - Phone:808-255-6482
Practice Address - Fax:808-836-3082
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILCSW-31691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00B0220265OtherHMSA
HI00B0220265OtherHMSA QUEST
HI571221345OtherALOHACARE
HI00B0220265OtherTRICARE
HI499328Medicaid
HI499328Medicaid