Provider Demographics
NPI:1861622425
Name:AU, SHARI (PHD)
Entity type:Individual
Prefix:DR
First Name:SHARI
Middle Name:
Last Name:AU
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:SHARI
Other - Middle Name:
Other - Last Name:AU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD, LLC
Mailing Address - Street 1:1702 KEWALO ST APT 403
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96822-3096
Mailing Address - Country:US
Mailing Address - Phone:808-398-4398
Mailing Address - Fax:
Practice Address - Street 1:1188 BISHOP ST STE 2904
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-3312
Practice Address - Country:US
Practice Address - Phone:808-398-4398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1132103TC2200X, 103TB0200X, 103TA0700X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI250700Medicaid
HI00D0288672OtherHAWAII MEDICAL SERVICE ASSOCIATION