Provider Demographics
NPI:1578257895
Name:FUNE, EBRAJEAN UILANI SILVA (LSW)
Entity Type:Individual
Prefix:
First Name:EBRAJEAN
Middle Name:UILANI SILVA
Last Name:FUNE
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:EBRAJEAN
Other - Middle Name:UILANI
Other - Last Name:SILVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:PO BOX 4566
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-0566
Mailing Address - Country:US
Mailing Address - Phone:808-936-5346
Mailing Address - Fax:808-982-5678
Practice Address - Street 1:15-1510 18TH AVENUE
Practice Address - Street 2:
Practice Address - City:KEAAU
Practice Address - State:HI
Practice Address - Zip Code:96749
Practice Address - Country:US
Practice Address - Phone:808-936-5346
Practice Address - Fax:808-982-5678
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-08
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI2090104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker