Provider Demographics
NPI:1699922393
Name:HEFFERNAN, JACOB KAWA'A (MAPC)
Entity type:Individual
Prefix:MR
First Name:JACOB
Middle Name:KAWA'A
Last Name:HEFFERNAN
Suffix:
Gender:M
Credentials:MAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 CORAL ST, FIRST FLOOR
Mailing Address - Street 2:CARE HAWAII, INC
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813
Mailing Address - Country:US
Mailing Address - Phone:808-791-6713
Mailing Address - Fax:
Practice Address - Street 1:606 CORAL ST, FIRST FLOOR
Practice Address - Street 2:CARE HAWAII, INC
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813
Practice Address - Country:US
Practice Address - Phone:808-791-6713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-25
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker