Provider Demographics
NPI:1871329441
Name:ISLAND PSYCHIATRIC CARE LLC
Entity type:Organization
Organization Name:ISLAND PSYCHIATRIC CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER, PMHNP
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HINOJOSA
Authorized Official - Suffix:
Authorized Official - Credentials:APRN-RX, PMHNP-BC
Authorized Official - Phone:808-344-7152
Mailing Address - Street 1:459 PALAMA DR
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732-1556
Mailing Address - Country:US
Mailing Address - Phone:808-344-7152
Mailing Address - Fax:
Practice Address - Street 1:1188 BISHOP ST STE 1810
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-3307
Practice Address - Country:US
Practice Address - Phone:808-344-7152
Practice Address - Fax:808-909-8411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-11
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty