NPI 1952019572

Jestyn Fonseca

Practitioner Driver Aiea, HI

Practice location

Address: 99-411 Pilikoa St, Aiea, HI 96701-3554
Phone: (808) 728-5454

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X Licence H01408342 (HI)

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Registry record

NPI: 1952019572
Entity type: Individual
Sex (as registered): Male
NPI issued: 14 Nov 2022
Record last updated: 14 Nov 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.