Provider Demographics
NPI:1760659643
Name:HANOHANO, CAROLYN JOANNE ONTIVEROS (PHD, PMHNP-BC, APRN)
Entity type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:JOANNE ONTIVEROS
Last Name:HANOHANO
Suffix:
Gender:F
Credentials:PHD, PMHNP-BC, APRN
Other - Prefix:
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Mailing Address - Street 1:800 S VICTORIA AVE # 4615
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93009-0003
Mailing Address - Country:US
Mailing Address - Phone:805-766-0883
Mailing Address - Fax:805-339-1128
Practice Address - Street 1:800 S VICTORIA AVE # 4615
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93009-1647
Practice Address - Country:US
Practice Address - Phone:805-766-0883
Practice Address - Fax:805-339-1128
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-10
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA576785163WP0808X, 171M00000X
CA95030733363LP0808X, 2084P0804X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry