Provider Demographics
NPI:1093309502
Name:JONES, GIGI NATACIA
Entity Type:Individual
Prefix:
First Name:GIGI
Middle Name:NATACIA
Last Name:JONES
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 1:91-1041 PUAHALA ST APT 26A
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-2158
Mailing Address - Country:US
Mailing Address - Phone:808-861-7489
Mailing Address - Fax:
Practice Address - Street 1:94-110 LEOKANE ST
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-2248
Practice Address - Country:US
Practice Address - Phone:808-861-7489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-24
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMHC-829101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health