Healthcare Provider Details

I. General information

NPI: 1417812769
Provider Name (Legal Business Name): KIMBERLY ALIPIO OCHINANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91-1135 KEAALII PL
EWA BEACH HI
96706-4509
US

IV. Provider business mailing address

91-1135 KEAALII PL
EWA BEACH HI
96706-4509
US

V. Phone/Fax

Practice location:
  • Phone: 661-543-7189
  • Fax:
Mailing address:
  • Phone: 661-543-7189
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN-123188
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: