Healthcare Provider Details

I. General information

NPI: 1124593504
Provider Name (Legal Business Name): SEX THERAPY HAWAII, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2018
Last Update Date: 04/20/2022
Certification Date: 04/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 KAPIOLANI BLVD STE 1340
HONOLULU HI
96814-3806
US

IV. Provider business mailing address

PO BOX 235292
HONOLULU HI
96823-3504
US

V. Phone/Fax

Practice location:
  • Phone: 808-225-2780
  • Fax:
Mailing address:
  • Phone: 773-888-3312
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. JANET BRITO
Title or Position: CEO
Credential: PSY
Phone: 773-888-3312