Doctor Name: | DR. LISA NOBUKO ORIMOTO |
NPI Number: | 1124062377 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | 629 |
Business Practice Address: | 98-211 Pali Momi St Suite 635 Aiea, HI - 967014301 |
Business Phone Number: | 8085545901 |
Business Fax Number: | |
Mailing Address: | Po Box 724, PEARL CITY |
State: | HI |
Postal Code: | 967820724 |
Phone Number: | 8084848901 |
Fax Number: | |
NPI Enumeration Date: | 06/16/2006 |
NPI Last Update Date: | 11/19/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 629 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | HI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |