Provider Demographics
NPI:1992293021
Name:SUMIDA, KRISTI LEE (NCC)
Entity type:Individual
Prefix:MRS
First Name:KRISTI
Middle Name:LEE
Last Name:SUMIDA
Suffix:
Gender:F
Credentials:NCC
Other - Prefix:MS
Other - First Name:KRISTI
Other - Middle Name:LEE
Other - Last Name:RAPOZO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MHC
Mailing Address - Street 1:4020 MAPU PL
Mailing Address - Street 2:
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766-9633
Mailing Address - Country:US
Mailing Address - Phone:808-651-5330
Mailing Address - Fax:
Practice Address - Street 1:2959 UMI ST
Practice Address - Street 2:
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-1806
Practice Address - Country:US
Practice Address - Phone:808-245-2873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-24
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty