Provider Demographics
NPI:1649925579
Name:HONG, CHRISTINA OLIVIA
Entity type:Individual
Prefix:MISS
First Name:CHRISTINA
Middle Name:OLIVIA
Last Name:HONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1388 ALA MOANA BLVD APT 2704
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-4651
Mailing Address - Country:US
Mailing Address - Phone:808-224-6726
Mailing Address - Fax:
Practice Address - Street 1:4680 KALANIANAOLE HWY
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96821-1241
Practice Address - Country:US
Practice Address - Phone:808-305-0500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-18
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRBT-23-284321106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician