Provider Demographics
NPI:1255688198
Name:SHIMOKAWA, KRISTINA CHANCE (LMFT)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:CHANCE
Last Name:SHIMOKAWA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:MARILYN
Other - Last Name:CHANCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:352 S HIGH ST
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-2104
Mailing Address - Country:US
Mailing Address - Phone:415-244-2446
Mailing Address - Fax:
Practice Address - Street 1:660 LONO AVE
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-2530
Practice Address - Country:US
Practice Address - Phone:808-727-4185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-09
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor