Healthcare Provider Details
I. General information
NPI: 1841120474
Provider Name (Legal Business Name): VICTORIA A LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/24/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1520 LILIHA ST
HONOLULU HI
96817-3562
US
IV. Provider business mailing address
1816 PALAMOI ST
PEARL CITY HI
96782-1563
US
V. Phone/Fax
- Phone: 808-367-2935
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225700000X |
| Taxonomy | Massage Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
VICTORIA
ACOSTA
Title or Position: LICENSED MASSAGE THERAPIST
Credential:
Phone: 808-367-2935