Healthcare Provider Details

I. General information

NPI: 1013832757
Provider Name (Legal Business Name): CORI MIE FUJIURA-DELA CRUZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1002 ALA KAPUA ST
HONOLULU HI
96818-2338
US

IV. Provider business mailing address

1002 ALA KAPUA ST
HONOLULU HI
96818-2338
US

V. Phone/Fax

Practice location:
  • Phone: 808-306-2216
  • Fax:
Mailing address:
  • Phone: 808-306-2214
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number5327
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: