Healthcare Provider Details

I. General information

NPI: 1891884912
Provider Name (Legal Business Name): SUZETTE TERUKO TOKUDA PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98-211 PALI MOMI ST SUITE 606
AIEA HI
96701-4301
US

IV. Provider business mailing address

98-211 PALI MOMI ST SUITE 606
AIEA HI
96701-4301
US

V. Phone/Fax

Practice location:
  • Phone: 808-358-3583
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY-767
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: