Provider Demographics
NPI:1235859539
Name:COLOMA, ROCHELLE (PA-C)
Entity type:Individual
Prefix:
First Name:ROCHELLE
Middle Name:
Last Name:COLOMA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98-211 PALI MOMI ST STE 312
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-4306
Mailing Address - Country:US
Mailing Address - Phone:808-486-0449
Mailing Address - Fax:808-488-0725
Practice Address - Street 1:98-211 PALI MOMI ST STE 312
Practice Address - Street 2:
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-4306
Practice Address - Country:US
Practice Address - Phone:808-486-0449
Practice Address - Fax:808-488-0725
Is Sole Proprietor?:No
Enumeration Date:2022-08-29
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
HIAMD-1372363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program