Provider Demographics
NPI:1033468392
Name:KOJIMA, JESSICA H
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:H
Last Name:KOJIMA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:742 HAUOLI ST APT C
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-3624
Mailing Address - Country:US
Mailing Address - Phone:808-651-6324
Mailing Address - Fax:
Practice Address - Street 1:742 HAUOLI ST APT C
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-3624
Practice Address - Country:US
Practice Address - Phone:808-651-6324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-02
Last Update Date:2012-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent