Provider Demographics
NPI:1124691571
Name:MADRIAGA-AGUIGUI, JASLYN
Entity type:Individual
Prefix:
First Name:JASLYN
Middle Name:
Last Name:MADRIAGA-AGUIGUI
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 1:99-149 KOHOMUA ST APT 22E
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-3720
Mailing Address - Country:US
Mailing Address - Phone:808-393-0499
Mailing Address - Fax:
Practice Address - Street 1:1147 KUMANO ST
Practice Address - Street 2:
Practice Address - City:PEARL CITY
Practice Address - State:HI
Practice Address - Zip Code:96782-1579
Practice Address - Country:US
Practice Address - Phone:808-307-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-22
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician