Healthcare Provider Details

I. General information

NPI: 1740375161
Provider Name (Legal Business Name): CARLYN A TAMURA PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 KAPIOLANI BOULEVARD SUITE 1323
HONOLULU HI
96814
US

IV. Provider business mailing address

820 MILILANI STREET 702A
HONOLULU HI
96813
US

V. Phone/Fax

Practice location:
  • Phone: 808-942-9733
  • Fax: 808-942-9734
Mailing address:
  • Phone: 808-523-9363
  • Fax: 808-523-9418

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY786
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: