Healthcare Provider Details

I. General information

NPI: 1649719261
Provider Name (Legal Business Name): LORI EMI ESAKI MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2017
Last Update Date: 11/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1380 LUSITANA ST STE 300
HONOLULU HI
96813-2449
US

IV. Provider business mailing address

66-485 KILIOE PL
HALEIWA HI
96712-1430
US

V. Phone/Fax

Practice location:
  • Phone: 808-691-7546
  • Fax:
Mailing address:
  • Phone: 808-631-7097
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFT-500
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: