Provider Demographics
NPI:1013760057
Name:FUKUMOTO, JULIA M (LMFT)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:M
Last Name:FUKUMOTO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:M
Other - Last Name:DUNCAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:609 N JUDD ST APT B
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-2273
Mailing Address - Country:US
Mailing Address - Phone:808-381-8303
Mailing Address - Fax:
Practice Address - Street 1:609 N JUDD ST APT B
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-2273
Practice Address - Country:US
Practice Address - Phone:808-381-8303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMFT-903106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist