Kokua Villa, Inc.

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Legal business name

KOKUA VILLA, INC.

Practice address

86-080 Farrington Hwy
Suite 102
Waianae, HI 96792-3069

Phone

(808) 696-7000

Fax

(808) 696-7003

NPI assigned

Jun 17, 2009

Organization subpart

No

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

Authorized official

Name

Ms. Rosaline G. Whitlock

Title

President/Owner

Phone

(808) 696-7000

Specialties & licenses 3

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1245196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245196800000",
    "number": "1841427739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86-080 FARRINGTON HWY",
            "address_2": "SUITE 102",
            "city": "WAIANAE",
            "state": "HI",
            "postal_code": "967923069",
            "telephone_number": "808-696-7000",
            "fax_number": "808-696-7003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86-080 FARRINGTON HWY",
            "address_2": "SUITE 102",
            "city": "WAIANAE",
            "state": "HI",
            "postal_code": "967923069",
            "telephone_number": "808-696-7000",
            "fax_number": "808-696-7003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOKUA VILLA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-17",
        "last_updated": "2009-06-17",
        "status": "A",
        "authorized_official_last_name": "WHITLOCK",
        "authorized_official_first_name": "ROSALINE",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "808-696-7000",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "HI",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "HI",
            "license": null,
            "primary": false
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "HI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "516908",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bong Jik Kim, M.D.
• Kasha Kim, PSYD
• Cynthia Delores King, RDN, LDN, CDE
• Kingdom Chiropractic
• Supriya Koirala, DMD
• Jared Yoshiaki Kumasaka Sr., RPH
• Joline L Labbe, FNP, APRN-RX
• Jacqueline Marie Lagman Zajac, FNP-BC
• Kacy Renee Lane, D.D.S.
• Darien Christian Lau

• Developmental Disabilities Clinic/Center in Waianae, HI
• Providers in Waianae, HI by specialty
• Developmental Disabilities Clinic/Center in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2009; 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.