Provider Demographics
NPI:1487080719
Name:LOUREIRO, NIKIMA TANGERINE
Entity type:Individual
Prefix:
First Name:NIKIMA
Middle Name:TANGERINE
Last Name:LOUREIRO
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:BLDG #50, FARENHOLT AVE
Mailing Address - Street 2:U.S. NAVAL HOSPITAL GUAM
Mailing Address - City:AGANA HEIGHTS
Mailing Address - State:GU
Mailing Address - Zip Code:96910
Mailing Address - Country:US
Mailing Address - Phone:671-344-9401
Mailing Address - Fax:
Practice Address - Street 1:BLDG #50, FARENHOLT AVE,
Practice Address - Street 2:
Practice Address - City:AGANA HEIGHTS
Practice Address - State:GU
Practice Address - Zip Code:96910
Practice Address - Country:US
Practice Address - Phone:671-344-9401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-18
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILCSW-38691041C0700X
HI38691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical