Provider Demographics
NPI:1447320031
Name:UYEKUBO, STACY
Entity type:Individual
Prefix:DR
First Name:STACY
Middle Name:
Last Name:UYEKUBO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2855 E MANOA RD STE 105, #337
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96822-1854
Mailing Address - Country:US
Mailing Address - Phone:808-234-3421
Mailing Address - Fax:808-797-2422
Practice Address - Street 1:2855 E MANOA RD STE 105, #337
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96822-1854
Practice Address - Country:US
Practice Address - Phone:808-234-3421
Practice Address - Fax:808-797-2422
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI147702084P0800X
CAA842082084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry