Provider Demographics
NPI:1699964825
Name:JOHNSON & CHAVEZ COMPANY INC
Entity type:Organization
Organization Name:JOHNSON & CHAVEZ COMPANY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:M
Authorized Official - Last Name:CHAVEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD MFT
Authorized Official - Phone:808-322-9288
Mailing Address - Street 1:PO BOX 541
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96745-0541
Mailing Address - Country:US
Mailing Address - Phone:808-322-9288
Mailing Address - Fax:855-242-0396
Practice Address - Street 1:75-5744 ALII DR
Practice Address - Street 2:SUITE 247
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-1784
Practice Address - Country:US
Practice Address - Phone:808-322-9288
Practice Address - Fax:855-242-0396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-24
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1174103TC0700X
HI110106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty