Provider Demographics
NPI:1437654308
Name:FOJAS-CALIMPONG, REBECCA CLAIRE (AGNP)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:CLAIRE
Last Name:FOJAS-CALIMPONG
Suffix:
Gender:F
Credentials:AGNP
Other - Prefix:MRS
Other - First Name:REBECCA
Other - Middle Name:CLAIRE
Other - Last Name:FOJAS-CALIMPONG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:AGNP-C
Mailing Address - Street 1:277 OHUA AVE
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-6612
Mailing Address - Country:US
Mailing Address - Phone:808-922-4787
Mailing Address - Fax:
Practice Address - Street 1:277 OHUA AVE
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815
Practice Address - Country:US
Practice Address - Phone:808-922-4787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-24
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI2367363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care