Healthcare Provider Details
I. General information
NPI: 1265845382
Provider Name (Legal Business Name): JOSE ROJALES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/05/2014
Last Update Date: 03/09/2023
Certification Date: 03/09/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
210 WARD AVE 219B
HONOLULU HI
96814-4008
US
IV. Provider business mailing address
7247 KIPU PL
HONOLULU HI
96825-2717
US
V. Phone/Fax
- Phone: 808-585-1424
- Fax: 808-585-0379
- Phone: 415-217-9468
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | 822 |
| License Number State | HI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: