Provider Demographics
NPI:1285439356
Name:CASABAY, JENICE AGCAOILI
Entity type:Individual
Prefix:
First Name:JENICE
Middle Name:AGCAOILI
Last Name:CASABAY
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 1:94-582 LOAA ST
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-1510
Mailing Address - Country:US
Mailing Address - Phone:808-548-8795
Mailing Address - Fax:
Practice Address - Street 1:94-582 LOAA ST
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-1510
Practice Address - Country:US
Practice Address - Phone:808-548-8795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-13
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency