Healthcare Provider Details

I. General information

NPI: 1508128802
Provider Name (Legal Business Name): CINDY GOODNESS ZANE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2012
Last Update Date: 06/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 S KING ST SUITE 311
HONOLULU HI
96826-3154
US

IV. Provider business mailing address

2525 S KING ST SUITE 311
HONOLULU HI
96826-3154
US

V. Phone/Fax

Practice location:
  • Phone: 808-949-1555
  • Fax: 808-949-1554
Mailing address:
  • Phone: 808-949-1555
  • Fax: 808-949-1554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY1198
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License NumberPSY1198
License Number StateHI
# 3
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License NumberPSY1198
License Number StateHI

VIII. Authorized Official

Name: DR. CINDY GOODNESS ZANE
Title or Position: OWNER
Credential: PSY.D.
Phone: 808-949-1555