Healthcare Provider Details

I. General information

NPI: 1336070960
Provider Name (Legal Business Name): VICTORIA ACOSTA
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 LILIHA ST STE 711B
HONOLULU HI
96817-3562
US

IV. Provider business mailing address

1520 LILIHA ST STE 711B
HONOLULU HI
96817-3562
US

V. Phone/Fax

Practice location:
  • Phone: 808-367-2935
  • Fax:
Mailing address:
  • Phone: 808-367-2935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMAT-18422
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: