Healthcare Provider Details

I. General information

NPI: 1982860516
Provider Name (Legal Business Name): RIEKO YONEDA BARRETO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2008
Last Update Date: 09/18/2020
Certification Date: 09/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75-5751 KUAKINI HWY SUITE #203
KAILUA KONA HI
96740
US

IV. Provider business mailing address

75-5751 KUAKINI HWY SUITE #203
KAILUA KONA HI
96740
US

V. Phone/Fax

Practice location:
  • Phone: 808-326-5629
  • Fax:
Mailing address:
  • Phone: 808-326-3897
  • Fax: 808-329-9370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2921
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code363LC1500X
TaxonomyCommunity Health Nurse Practitioner
License Number15207
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code363LX0106X
TaxonomyOccupational Health Nurse Practitioner
License Number15027
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code363LC1500X
TaxonomyCommunity Health Nurse Practitioner
License Number20044
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: