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General NPI Number Information
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NPI Number | 1962162453
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Entity Type | Individual
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Provider Name | MELISSA NJERI GATHURA
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Gender | Female
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Dates
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Enumeration Date | 12/23/2021
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Last Update Date | 12/23/2021
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Provider Practice Location Address
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Address Line | 642 MEAKANU LN APT 2004
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City | WAILUKU
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State | HI
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Zip | 96793-2944
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Country | US
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Telephone | 808-357-4214
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Fax |
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Provider Business Mailing Address
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Address Line | 5022 BOOMER ST APT C
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City | KAPOLEI
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State | HI
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Zip | 96707-3659
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Country | US
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Telephone | 661-472-7234
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 23002
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License Number State | CA
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