Provider Demographics
NPI:1740549484
Name:CHUNG, KRISTINA LEHUANANI
Entity type:Individual
Prefix:MS
First Name:KRISTINA
Middle Name:LEHUANANI
Last Name:CHUNG
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 1:349 HANAKAI ST
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732-3414
Mailing Address - Country:US
Mailing Address - Phone:808-269-7357
Mailing Address - Fax:808-873-9696
Practice Address - Street 1:349 HANAKAI ST
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-3414
Practice Address - Country:US
Practice Address - Phone:808-269-7357
Practice Address - Fax:808-873-9696
Is Sole Proprietor?:No
Enumeration Date:2012-05-15
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator