Provider Demographics
NPI:1568581783
Name:KAIAMA, VICTORIA LUPUA (LICENSE)
Entity Type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:LUPUA
Last Name:KAIAMA
Suffix:
Gender:F
Credentials:LICENSE
Other - Prefix:MISS
Other - First Name:VICTORIA
Other - Middle Name:LUPUA
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:94-944 LUMIMOE ST
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-3948
Mailing Address - Country:US
Mailing Address - Phone:808-677-0174
Mailing Address - Fax:
Practice Address - Street 1:94-944 LUMIMOE ST
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-3948
Practice Address - Country:US
Practice Address - Phone:808-677-0174
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIW02901330-01225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist