Provider Demographics
NPI:1659528867
Name:JAVIER, FERNANDO ORCELINO (MA)
Entity Type:Individual
Prefix:MR
First Name:FERNANDO
Middle Name:ORCELINO
Last Name:JAVIER
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 MOHOULI ST
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-4146
Mailing Address - Country:US
Mailing Address - Phone:808-961-5166
Mailing Address - Fax:
Practice Address - Street 1:77 MOHOULI ST
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-4146
Practice Address - Country:US
Practice Address - Phone:808-961-5166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-19
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist