Provider Demographics
NPI:1346810983
Name:ISHIKAWA, LEISHA MIEKO
Entity type:Individual
Prefix:
First Name:LEISHA
Middle Name:MIEKO
Last Name:ISHIKAWA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 KUHILANI ST
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-3196
Mailing Address - Country:US
Mailing Address - Phone:808-443-8754
Mailing Address - Fax:
Practice Address - Street 1:69 RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-7509
Practice Address - Country:US
Practice Address - Phone:808-935-7949
Practice Address - Fax:808-934-8318
Is Sole Proprietor?:No
Enumeration Date:2021-06-27
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14960101YP2500X
HI101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional