Healthcare Provider Details

I. General information

NPI: 1245164110
Provider Name (Legal Business Name): JENNIFER MICHELLE RAMOS MFTP-25
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2176 LAUWILIWILI ST STE 1
KAPOLEI HI
96707-1882
US

IV. Provider business mailing address

87-1152 ANAHA ST
WAIANAE HI
96792-5409
US

V. Phone/Fax

Practice location:
  • Phone: 808-272-5355
  • Fax: 808-200-4955
Mailing address:
  • Phone: 808-483-0338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFTP-25
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: