Provider Demographics
NPI:1144472507
Name:CANTORNA, VIRGINIA T (PSYD)
Entity type:Individual
Prefix:DR
First Name:VIRGINIA
Middle Name:T
Last Name:CANTORNA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 S WAKEA AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732
Mailing Address - Country:US
Mailing Address - Phone:808-385-0051
Mailing Address - Fax:
Practice Address - Street 1:135 S WAKEA AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732
Practice Address - Country:US
Practice Address - Phone:808-385-0051
Practice Address - Fax:808-242-8920
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-16
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist