Provider Demographics
NPI:1245028695
Name:HIGA, WULAN ANGGRAENI
Entity type:Individual
Prefix:
First Name:WULAN
Middle Name:ANGGRAENI
Last Name:HIGA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 ILIMANO ST
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-1825
Mailing Address - Country:US
Mailing Address - Phone:808-254-1129
Mailing Address - Fax:
Practice Address - Street 1:331 ILIMANO ST # A
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-1825
Practice Address - Country:US
Practice Address - Phone:808-254-1129
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician