Provider Demographics
NPI:1104881283
Name:EFSTATION, JAMES FARTHING (PHD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:FARTHING
Last Name:EFSTATION
Suffix:
Gender:M
Credentials:PHD
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 115
Mailing Address - Street 2:
Mailing Address - City:KAPAAU
Mailing Address - State:HI
Mailing Address - Zip Code:96755-0115
Mailing Address - Country:US
Mailing Address - Phone:808-889-6200
Mailing Address - Fax:
Practice Address - Street 1:54-3885 AKONIPULE HWY
Practice Address - Street 2:#211-D
Practice Address - City:KAPAAU
Practice Address - State:HI
Practice Address - Zip Code:96755
Practice Address - Country:US
Practice Address - Phone:808-889-6200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-20
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI769103TC0700X
NC1457103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000238139OtherHMSA
HI52137901Medicaid
HI52137901Medicaid