Provider Demographics
NPI:1821541996
Name:FUNGAVAKA, VIKA KALEHUA
Entity Type:Individual
Prefix:MRS
First Name:VIKA
Middle Name:KALEHUA
Last Name:FUNGAVAKA
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:VIKA
Other - Middle Name:KALEHUA
Other - Last Name:NAA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5919 SIMONS DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89523-2569
Mailing Address - Country:US
Mailing Address - Phone:310-242-0968
Mailing Address - Fax:
Practice Address - Street 1:5919 SIMONS DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89523-2569
Practice Address - Country:US
Practice Address - Phone:310-242-0968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-25
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor