Healthcare Provider Details

I. General information

NPI: 1225992811
Provider Name (Legal Business Name): JASMINE MALINA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 WAIMANU ST
HONOLULU HI
96814-3427
US

IV. Provider business mailing address

45-119 WAIKAPOKI RD APT 1
KANEOHE HI
96744-2778
US

V. Phone/Fax

Practice location:
  • Phone: 808-386-9756
  • Fax:
Mailing address:
  • Phone: 808-386-9756
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: