Healthcare Provider Details

I. General information

NPI: 1003400995
Provider Name (Legal Business Name): JO ANN SAEKO SAKAI MS CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2021
Last Update Date: 02/22/2021
Certification Date: 02/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94-1181 KA UKA BLVD STE C
WAIPAHU HI
96797-4485
US

IV. Provider business mailing address

94-1181 KA UKA BLVD STE C
WAIPAHU HI
96797-4485
US

V. Phone/Fax

Practice location:
  • Phone: 808-260-9056
  • Fax: 877-518-7858
Mailing address:
  • Phone: 808-260-9056
  • Fax: 877-518-7858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP-404
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: