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Individual

MRS. JENNY DOMINGO PONCIANO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
94-1132 LUMIAUAU ST, WAIPAHU, HI 96797-3922
(808) 636-1274
(808) 082-6041
Mailing address
94-1132 LUMIAUAU ST, WAIPAHU, HI 96797-3922
(808) 636-1274
(808) 082-6041

Taxonomy

Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
1-200047
HI

Other

Enumeration date
01/05/2021
Last updated
01/05/2021
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