Individual provider Active NPI

Julianna Moefu-Kaleopa, LCSW/CSAC

  • Clinical Social Worker
  • Honolulu, HI
National Provider Identifier
1396995114
Registry record updated Dec 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4406 Issued in HI
Practice address
200 N Vineyard Blvd Ste 501
Honolulu, HI 96817-3952
Phone
(808) 599-7508
Fax
(808) 599-7509
NPI assigned
Sep 29, 2008
Last updated
Dec 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Clinical Social Worker 1041C0700X 4406 HI Primary

Addresses

Primary practice location

200 N Vineyard Blvd Ste 501
Honolulu, HI 96817-3952

Mailing address

200 N Vineyard Blvd Ste 330
Honolulu, HI 96817-3938
Phone (808) 599-7508

Other identifiers 1

IdentifierTypeStateIssuer
1396995114MedicaidHI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4406HIMDClinical Social Worker

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1222646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671062400000",
    "number": "1396995114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N VINEYARD BLVD STE 330",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968173938",
            "telephone_number": "808-599-7508",
            "fax_number": "808-599-7509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N VINEYARD BLVD STE 501",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968173952",
            "telephone_number": "808-599-7508",
            "fax_number": "808-599-7509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOEFU-KALEOPA",
        "first_name": "JULIANNA",
        "credential": "LCSW/CSAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-29",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "HI",
            "license": "4406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396995114",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.