Provider Demographics
NPI:1073010609
Name:ENGFER, KASSANDRA HELEN (EDD)
Entity type:Individual
Prefix:
First Name:KASSANDRA
Middle Name:HELEN
Last Name:ENGFER
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:DR
Other - First Name:KASSANDRA
Other - Middle Name:HELEN
Other - Last Name:MENDELSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:EDD
Mailing Address - Street 1:1330 ALAMOANA BOULEVARD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814
Mailing Address - Country:US
Mailing Address - Phone:808-585-0379
Mailing Address - Fax:808-585-0379
Practice Address - Street 1:1330 ALAMOANA BOULEVARD
Practice Address - Street 2:SUITE 1
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814
Practice Address - Country:US
Practice Address - Phone:808-585-0379
Practice Address - Fax:808-585-0379
Is Sole Proprietor?:No
Enumeration Date:2018-04-10
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001718-1103K00000X
HI461103K00000X
HIMHC461103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst