Healthcare Provider Details

I. General information

NPI: 1316606130
Provider Name (Legal Business Name): CIERRA YOSHIKAWA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2021
Last Update Date: 03/24/2023
Certification Date: 03/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 W HIND DR STE 210
HONOLULU HI
96821-1845
US

IV. Provider business mailing address

860 PAPALALO PL
HONOLULU HI
96825-2962
US

V. Phone/Fax

Practice location:
  • Phone: 808-941-9648
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHC-923
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: