Healthcare Provider Details

I. General information

NPI: 1366374993
Provider Name (Legal Business Name): MEIYI KIYOKO ANGEL PACHECO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 KAPIOLANI BLVD PH 50
HONOLULU HI
96814-3518
US

IV. Provider business mailing address

1464 THURSTON AVE APT A1
HONOLULU HI
96822-3640
US

V. Phone/Fax

Practice location:
  • Phone: 808-260-9893
  • Fax:
Mailing address:
  • Phone: 808-681-2197
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-5462
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: