Provider Demographics
NPI:1417116617
Name:LEFOTU, LAFAAUA M
Entity Type:Individual
Prefix:
First Name:LAFAAUA
Middle Name:M
Last Name:LEFOTU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LAFAAUA
Other - Middle Name:M
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:86-226 FARRINGTON HWY
Mailing Address - Street 2:
Mailing Address - City:WAIANAE
Mailing Address - State:HI
Mailing Address - Zip Code:96792-3128
Mailing Address - Country:US
Mailing Address - Phone:808-696-4211
Mailing Address - Fax:808-696-5516
Practice Address - Street 1:85-979 MILL ST
Practice Address - Street 2:
Practice Address - City:WAIANAE
Practice Address - State:HI
Practice Address - Zip Code:96792-2645
Practice Address - Country:US
Practice Address - Phone:808-696-9498
Practice Address - Fax:808-696-9403
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker