Provider Demographics
NPI:1043683725
Name:ACOSTA, JHOAN (CNA)
Entity Type:Individual
Prefix:MRS
First Name:JHOAN
Middle Name:
Last Name:ACOSTA
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1922 LOHILANI ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-4136
Mailing Address - Country:US
Mailing Address - Phone:808-842-4740
Mailing Address - Fax:808-842-4740
Practice Address - Street 1:1922 LOHILANI ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-4136
Practice Address - Country:US
Practice Address - Phone:808-842-4740
Practice Address - Fax:808-842-4740
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-04
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIH1020409958174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist