Healthcare Provider Details

I. General information

NPI: 1053883439
Provider Name (Legal Business Name): FAIR CLINICAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2018
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 KAMAKEE ST STE 405
HONOLULU HI
96814-4261
US

IV. Provider business mailing address

46-036 KAMEHAMEHA HWY UNIT 1552
KANEOHE HI
96744-7863
US

V. Phone/Fax

Practice location:
  • Phone: 808-282-9932
  • Fax: 419-893-0475
Mailing address:
  • Phone: 419-740-3052
  • Fax: 419-893-0475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINE A. FAIR
Title or Position: CEO
Credential: DR
Phone: 419-234-0590