Provider Demographics
NPI:1962940643
Name:KAGAMIDA, JAMIE KAORI (LMFT)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:KAORI
Last Name:KAGAMIDA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1706 KAWELOKA ST
Mailing Address - Street 2:
Mailing Address - City:PEARL CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96782-1521
Mailing Address - Country:US
Mailing Address - Phone:808-258-5480
Mailing Address - Fax:
Practice Address - Street 1:1706 KAWELOKA ST
Practice Address - Street 2:
Practice Address - City:PEARL CITY
Practice Address - State:HI
Practice Address - Zip Code:96782-1521
Practice Address - Country:US
Practice Address - Phone:808-258-5480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-02
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMFT 492106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist