Provider Demographics
NPI:1104383801
Name:NITTA, HOLLY (OT)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:NITTA
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:
Other - Last Name:FUJITA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:13609 CALIFORNIA ST STE 200
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-5245
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2230 LILIHA ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-1697
Practice Address - Country:US
Practice Address - Phone:808-554-7600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-28
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist