Provider Demographics
NPI:1780913087
Name:AH KIONG, CANDACE (LCSW)
Entity type:Individual
Prefix:
First Name:CANDACE
Middle Name:
Last Name:AH KIONG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:CANDACE
Other - Middle Name:
Other - Last Name:AH KIONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:92-428 KAIAULU ST
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-1005
Mailing Address - Country:US
Mailing Address - Phone:808-271-1645
Mailing Address - Fax:
Practice Address - Street 1:1 JARRETT WHITE RD
Practice Address - Street 2:
Practice Address - City:TRIPLER ARMY MEDICAL CENTER
Practice Address - State:HI
Practice Address - Zip Code:96859-5001
Practice Address - Country:US
Practice Address - Phone:808-433-1307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-15
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIVAD000OtherUPIN