Healthcare Provider Details

I. General information

NPI: 1326188905
Provider Name (Legal Business Name): RICHARD PAUL KAPPENBERG PH.D., ABMP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 04/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 BISHOP STREET SUITE 2870
HONOLULU HI
96813-3482
US

IV. Provider business mailing address

1001 BISHOP STREET SUITE 2870
HONOLULU HI
96813-3482
US

V. Phone/Fax

Practice location:
  • Phone: 808-538-7793
  • Fax: 808-538-7799
Mailing address:
  • Phone: 808-538-7793
  • Fax: 808-538-7799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberHI-PSY-106
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberHI-PSY-106
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: