Individual
DR. JODA P. DERRICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D, RD, ACSM EP-C
Contact information
Practice address
773 LAWELAWE ST, HONOLULU, HI 96821-1700
(808) 636-8830
Mailing address
773 LAWELAWE ST, HONOLULU, HI 96821-1700
(808) 636-8830
Taxonomy
Speciality
Code
Description
License number
State
133VN1006X
Metabolic Nutrition Registered Dietitian
—
—
225700000X
Massage Therapist
Primary
MAT17219
HI
Other
Enumeration date
02/29/2016
Last updated
06/30/2025
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