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General NPI Number Information
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NPI Number | 1033009188
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Entity Type | Organization
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Legal Business Name | PACIFIC PEER CONNECTION
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Dates
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Enumeration Date | 07/08/2025
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Last Update Date | 07/11/2025
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Provider Practice Location Address
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Address Line | 6301 PALI HWY
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City | KANEOHE
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State | HI
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Zip | 96744-5224
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Country | US
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Telephone | 808-221-6656
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 11004
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City | HONOLULU
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State | HI
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Zip | 96828-0004
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Country | US
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Telephone | 808-221-6656
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Fax |
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Authorized Official
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Title or Position | BOARD DIRECTOR
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Name | TONI BISSEN
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Credential |
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Telephone | 808-221-6656
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State |
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