Healthcare Provider Details

I. General information

NPI: 1033688437
Provider Name (Legal Business Name): GERILYN JULIAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2018
Last Update Date: 02/08/2025
Certification Date: 02/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94-637 KAHAKEA ST APT 3L
WAIPAHU HI
96797-1149
US

IV. Provider business mailing address

94-637 KAHAKEA ST APT 3L
WAIPAHU HI
96797-1149
US

V. Phone/Fax

Practice location:
  • Phone: 808-782-6056
  • Fax:
Mailing address:
  • Phone: 808-782-6056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-19-75327
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: