Provider Demographics
NPI:1902617947
Name:GINOZA, ALISHA KAEDE
Entity type:Individual
Prefix:MS
First Name:ALISHA
Middle Name:KAEDE
Last Name:GINOZA
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 1:94-539 PUAHI ST
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-6200
Mailing Address - Country:US
Mailing Address - Phone:808-591-6060
Mailing Address - Fax:
Practice Address - Street 1:94-539 PUAHI ST
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-6200
Practice Address - Country:US
Practice Address - Phone:808-591-6060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-17
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRBT-25-403274106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician