Kokua Kalihi Valley Comprehensive Family Services
Organization Active NPI Federally Qualified Health Center (FQHC) · Honolulu, HI
NPI 1548733397 · NPPES record last updated Jan 4, 2019
Key facts
- NPI
- 1548733397
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- KOKUA KALIHI VALLEY COMPREHENSIVE FAMILY SERVICES
- Practice address
- 3659 Kalihi St
Honolulu, HI 96819-3038 - Phone
- (808) 791-9400
- Fax
- (808) 848-0979
- NPI assigned
- Jan 4, 2019
- Organization subpart
- No
Authorized official
- Name
- Dr. David Derauf, MD
- Title
- Executive Director
- Phone
- (808) 791-9400
Other NPIs on the same Medicare enrollment 4
Practitioners 5
-
Erin Iwalani Castillo, LCSW
-
Christie H Izutsu, M.D.
-
Dustin Ken Teruya, LCSW
-
Carly C Williamson, LCSW
-
Ruth A Chong, FNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in HI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190401001159 | HI | Part B Supplier - Clinic/Group Practice | 0547258741 |
Receives reassigned benefits from 39 practitioners 4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Honolulu, HI |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
3659 Kalihi St
Honolulu, HI 96819-3038
Mailing address
2239 N School St
Honolulu, HI 96819-2539
Phone (808) 791-9413
Other providers in Honolulu, HI
- Kokua Healthcare
- Kokua Kalihi Valley Comprehensive Family Services
- Kokua Kalihi Valley Comprehensive Family Services
- Kokua Kalihi Valley Comprehensive Family Services
- Kokua Kalihi Valley Comprehensive Family Services
- Kokua Kalihi Valley Comprehensive Family Services
- Kokua Kalihi Valley Comprehensive Family Services
- Kokua Kalihi Valley Comprehensive Family Services
- Kokua Kalihi Valley Comprehensive Family Services
- Kokua Mental Health and Wellness LLC
All providers in Honolulu, HI · Federally Qualified Health Center (FQHC) in Hawaii
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 4, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.