Provider Demographics
NPI:1649967449
Name:BUNDA, JAMES ROBERT IKAIKA TOSHIYUKI (NCC)
Entity type:Individual
Prefix:
First Name:JAMES ROBERT
Middle Name:IKAIKA TOSHIYUKI
Last Name:BUNDA
Suffix:
Gender:M
Credentials:NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1745 ROYAL PALM DR
Mailing Address - Street 2:
Mailing Address - City:WAHIAWA
Mailing Address - State:HI
Mailing Address - Zip Code:96786-2642
Mailing Address - Country:US
Mailing Address - Phone:808-349-3043
Mailing Address - Fax:
Practice Address - Street 1:1745 ROYAL PALM DR
Practice Address - Street 2:
Practice Address - City:WAHIAWA
Practice Address - State:HI
Practice Address - Zip Code:96786-2642
Practice Address - Country:US
Practice Address - Phone:808-349-3043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-20
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health