Provider Demographics
NPI:1306313382
Name:FERREIRA, SONNY J
Entity type:Individual
Prefix:
First Name:SONNY
Middle Name:J
Last Name:FERREIRA
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 1:95-521 WEHEWEHE LOOP
Mailing Address - Street 2:
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-1410
Mailing Address - Country:US
Mailing Address - Phone:808-780-3609
Mailing Address - Fax:
Practice Address - Street 1:95-521 WEHEWEHE LOOP
Practice Address - Street 2:
Practice Address - City:MILILANI
Practice Address - State:HI
Practice Address - Zip Code:96789-1410
Practice Address - Country:US
Practice Address - Phone:808-780-3609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-29
Last Update Date:2022-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
HIMFT-769-0106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health