Provider Demographics
NPI:1366509291
Name:FUJIMOTO, JAMIE KEHAULANI (LCSW)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:KEHAULANI
Last Name:FUJIMOTO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:354 ULUNIU ST STE 203A
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-2528
Mailing Address - Country:US
Mailing Address - Phone:808-258-0018
Mailing Address - Fax:808-261-8083
Practice Address - Street 1:354 ULUNIU ST STE 203A
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2528
Practice Address - Country:US
Practice Address - Phone:808-258-0018
Practice Address - Fax:808-261-8083
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILCSW 32041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00C0243810OtherHMSA, HMSA QUEST
HI00C0243810OtherHMSA, HMSA QUEST