MEDICARE: ALEXANDINE GERVAIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor		HI

General Provider Information

NPI Number	:	1366374621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDINE GERVAIS

Provider Business Mailing Address
First Line	:	91-2067 KAIOLI ST EWA BEACH
Second Line	:
City	:	EWA BEACH
State	:	HI
Zip	:	96706
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	91-2067 KAIOLI ST EWA BEACH
Second Line	:
City	:	EWA BEACH
State	:	HI
Zip	:	96706
Country	:	US
Telephone Number	:	954-497-0467
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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Directions to “ ALEXANDINE GERVAIS ” Practice Location

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