Provider Demographics
NPI:1396995114
Name:MOEFU-KALEOPA, JULIANNA (LCSW/CSAC)
Entity type:Individual
Prefix:
First Name:JULIANNA
Middle Name:
Last Name:MOEFU-KALEOPA
Suffix:
Gender:F
Credentials:LCSW/CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 N VINEYARD BLVD STE 330
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-3938
Mailing Address - Country:US
Mailing Address - Phone:808-599-7508
Mailing Address - Fax:808-599-7509
Practice Address - Street 1:200 N VINEYARD BLVD STE 501
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-3952
Practice Address - Country:US
Practice Address - Phone:808-599-7508
Practice Address - Fax:808-599-7509
Is Sole Proprietor?:No
Enumeration Date:2008-09-29
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
HI44061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI1396995114Medicaid