Provider Demographics
NPI:1245487289
Name:EGUCHI, CHERISSE
Entity type:Individual
Prefix:
First Name:CHERISSE
Middle Name:
Last Name:EGUCHI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHERISSE
Other - Middle Name:
Other - Last Name:EGUCHI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2670 KELE ST
Mailing Address - Street 2:
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766
Mailing Address - Country:US
Mailing Address - Phone:808-589-1829
Mailing Address - Fax:808-589-2610
Practice Address - Street 1:2670 KELE ST
Practice Address - Street 2:
Practice Address - City:LIHUE KAUAI
Practice Address - State:HI
Practice Address - Zip Code:96766
Practice Address - Country:US
Practice Address - Phone:808-589-1829
Practice Address - Fax:808-589-2610
Is Sole Proprietor?:No
Enumeration Date:2008-08-21
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional