Healthcare Provider Details

I. General information

NPI: 1073476289
Provider Name (Legal Business Name): MRS. KRISTI EFFORD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 12/04/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17-550 VOLCANO RD
KURTISTOWN HI
96760
US

IV. Provider business mailing address

16-586 OLD VOLCANO RD STE 100
KEAAU HI
96749-8115
US

V. Phone/Fax

Practice location:
  • Phone: 808-646-3150
  • Fax:
Mailing address:
  • Phone: 619-219-4568
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberPRE-LICENSED
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: