Healthcare Provider Details

I. General information

NPI: 1831016641
Provider Name (Legal Business Name): KIMI-ANNE NISHIHARA OTD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KIMI ANDERSHOCK OTD

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1319 PUNAHOU ST
HONOLULU HI
96826-1028
US

IV. Provider business mailing address

1319 PUNAHOU ST DHT FL3 REHABILITATION
HONOLULU HI
96826
US

V. Phone/Fax

Practice location:
  • Phone: 808-983-8235
  • Fax:
Mailing address:
  • Phone: 808-983-8235
  • Fax: 808-983-6752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: