Healthcare Provider Details

I. General information

NPI: 1881152858
Provider Name (Legal Business Name): JOSEPH LOUIS HURTADO LMHC, NCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2019
Last Update Date: 02/02/2020
Certification Date: 02/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 CALIFORNIA AVE STE 212A
WAHIAWA HI
96786-1841
US

IV. Provider business mailing address

94-640 LUMIAUAU ST # A1
WAIPAHU HI
96797-5604
US

V. Phone/Fax

Practice location:
  • Phone: 808-777-0066
  • Fax: 808-484-9359
Mailing address:
  • Phone: 808-777-0066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number558
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: