Provider Demographics
NPI:1043023112
Name:DULLAGA, CRISTINA ELLORIN (CAREGIVER)
Entity type:Individual
Prefix:
First Name:CRISTINA
Middle Name:ELLORIN
Last Name:DULLAGA
Suffix:
Gender:F
Credentials:CAREGIVER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1657 MALAKIA ST
Mailing Address - Street 2:
Mailing Address - City:KAPAA
Mailing Address - State:HI
Mailing Address - Zip Code:96746-2079
Mailing Address - Country:US
Mailing Address - Phone:808-652-5526
Mailing Address - Fax:808-320-3253
Practice Address - Street 1:1657 MALAKIA ST
Practice Address - Street 2:
Practice Address - City:KAPAA
Practice Address - State:HI
Practice Address - Zip Code:96746-2079
Practice Address - Country:US
Practice Address - Phone:808-652-5526
Practice Address - Fax:808-320-3253
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIHI0204011193747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant