Provider Demographics
NPI:1922482579
Name:ATIJERA, REMEDIOS
Entity Type:Individual
Prefix:
First Name:REMEDIOS
Middle Name:
Last Name:ATIJERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BHENG
Other - Middle Name:
Other - Last Name:ATIJERA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:496 KAIWAHINE ST
Mailing Address - Street 2:
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-7641
Mailing Address - Country:US
Mailing Address - Phone:808-875-9122
Mailing Address - Fax:
Practice Address - Street 1:496 KAIWAHINE ST
Practice Address - Street 2:
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-7641
Practice Address - Country:US
Practice Address - Phone:808-385-9122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-14
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI8700173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist