Provider Demographics
NPI:1104192855
Name:KAMIYAMA, EREN MISA (MFT)
Entity Type:Individual
Prefix:MISS
First Name:EREN
Middle Name:MISA
Last Name:KAMIYAMA
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 ULUNIU ST APT A
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-2550
Mailing Address - Country:US
Mailing Address - Phone:808-391-3736
Mailing Address - Fax:
Practice Address - Street 1:45-270 WILLIAM HENRY RD STE 207
Practice Address - Street 2:
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-5808
Practice Address - Country:US
Practice Address - Phone:808-391-3736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-27
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI309106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist