Healthcare Provider Details

I. General information

NPI: 1821904301
Provider Name (Legal Business Name): JESSICA SASABE AMHC, M.A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99-080 KAUHALE ST STE C20
AIEA HI
96701-4114
US

IV. Provider business mailing address

94-1049 KAAHOLO ST
WAIPAHU HI
96797-1200
US

V. Phone/Fax

Practice location:
  • Phone: 808-953-4682
  • Fax:
Mailing address:
  • Phone: 808-485-7441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHCP-11
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: