Tisha Trujillo Cornett, LCSW, BCD
Individual provider Active NPI Clinical Social Worker · Jbphh, HI
NPI 1811069016 · NPPES record last updated Sep 14, 2023
Key facts
- NPI
- 1811069016
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 3306 (KY)
- Practice address
- 755 Scott Cir
Jbphh, HI 96853-5399 - Phone
- (808) 448-6377
- NPI assigned
- Nov 14, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3306 | KY | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 3306 | KY | Yes |
Addresses
Primary practice location
755 Scott Cir
Jbphh, HI 96853-5399
Mailing address
755 Scott Cir
Jbphh, HI 96853-5399
Phone (808) 448-6377
Other providers in Jbphh, HI
- Connie Yooran Chung
- Suzanne Clayton
- Yvonne Flonnory Cobb
- Ian Cochran
- Marsha Sharene Collins
- Shelley Corson
- Brittany Mackey Coy
- Andrew Crane
- Steven Samuel Danna
- Brodie Darlow
All providers in Jbphh, HI · Clinical Social Worker in Hawaii
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 14, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.