Healthcare Provider Details

I. General information

NPI: 1245758549
Provider Name (Legal Business Name): JOSEPHINE P. HORITA, D.O. LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2017
Last Update Date: 09/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4211 WAIALAE AVE STE 208
HONOLULU HI
96816-5312
US

IV. Provider business mailing address

1842 MAHANA ST
HONOLULU HI
96816-2995
US

V. Phone/Fax

Practice location:
  • Phone: 808-542-7349
  • Fax: 808-732-6433
Mailing address:
  • Phone: 808-234-9993
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License NumberDOS-1267
License Number StateHI

VIII. Authorized Official

Name: DR. JOSEPHINE P. HORITA
Title or Position: CHILD AND ADOLESCENT PSYCHIATRIST
Credential: DO
Phone: 808-234-9993