Provider Demographics
NPI:1952033961
Name:NUNES, JEFFREY (BA)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:NUNES
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 235702
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96823-3511
Mailing Address - Country:US
Mailing Address - Phone:808-523-2347
Mailing Address - Fax:
Practice Address - Street 1:95-1060 LEHIWA DR APT 3225
Practice Address - Street 2:
Practice Address - City:MILILANI
Practice Address - State:HI
Practice Address - Zip Code:96789-6635
Practice Address - Country:US
Practice Address - Phone:808-476-4866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-28
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI4201329101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)