Healthcare Provider Details

I. General information

NPI: 1356274880
Provider Name (Legal Business Name): EMILEE CHOCK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 WAIMANU ST APT 103
HONOLULU HI
96814-3427
US

IV. Provider business mailing address

45-569 DUNCAN DR
KANEOHE HI
96744-2015
US

V. Phone/Fax

Practice location:
  • Phone: 808-797-5043
  • Fax: 213-325-9172
Mailing address:
  • Phone: 808-489-3612
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: