Provider Demographics
NPI:1487149829
Name:CARIAGA, JONATHAN (LMFT)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
Last Name:CARIAGA
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92-1242 HOOKOMO ST
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-1525
Mailing Address - Country:US
Mailing Address - Phone:562-412-4264
Mailing Address - Fax:
Practice Address - Street 1:92-1242 HOOKOMO ST
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-1525
Practice Address - Country:US
Practice Address - Phone:562-412-4264
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-28
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI541106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist