Healthcare Provider Details

I. General information

NPI: 1356261655
Provider Name (Legal Business Name): CASSIA FREITAS
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 N VINEYARD BLVD # A-600
HONOLULU HI
96817-3950
US

IV. Provider business mailing address

710 GREEN ST
HONOLULU HI
96813-2119
US

V. Phone/Fax

Practice location:
  • Phone: 808-940-7203
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: