| Larisa Nebre, Llc | |
|
4343 Aalona St Kilauea HI 96754-5344 | |
| (808) 635-2114 | |
| Not Available |
| Full Name | Larisa Nebre, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 4343 Aalona St, Kilauea, Hawaii |
| Authorized Official Name and Position | Larisa Hisako Nebre (OWNER) |
| Authorized Official Contact | 8086352114 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Larisa Nebre, Llc 4343 Aalona St Kilauea HI 96754-5344 Ph: (808) 635-2114 | Larisa Nebre, Llc 4343 Aalona St Kilauea HI 96754-5344 Ph: (808) 635-2114 |
| NPI Number | 1003678558 |
|---|---|
| Provider Enumeration Date | 01/29/2024 |
| Last Update Date | 01/29/2024 |
| Certification Date | 01/29/2024 |
| Medicare PECOS PAC ID | 6103369558 |
|---|---|
| Medicare Enrollment ID | O20240613003868 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003678558 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | La Risa Hisako Nebre |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407623143 PECOS PAC ID: 7911440367 Enrollment ID: I20240613003945 |
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