Healthcare Provider Details

I. General information

NPI: 1700741287
Provider Name (Legal Business Name): KAIULU WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 HUAALANI DR
HILO HI
96720-1902
US

IV. Provider business mailing address

7 HUAALANI DR
HILO HI
96720-1902
US

V. Phone/Fax

Practice location:
  • Phone: 808-230-3635
  • Fax:
Mailing address:
  • Phone: 808-230-3635
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JENNA WAIPA
Title or Position: THERAPIST
Credential: LMFT
Phone: 808-230-3635