Healthcare Provider Details

I. General information

NPI: 1811672975
Provider Name (Legal Business Name): CHLOE KAZUMI PUANANI GABRIEL PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2023
Last Update Date: 08/01/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 PIIKOI ST STE 1503
HONOLULU HI
96814-3160
US

IV. Provider business mailing address

615 PIIKOI ST STE 1503
HONOLULU HI
96814-3160
US

V. Phone/Fax

Practice location:
  • Phone: 808-779-5807
  • Fax:
Mailing address:
  • Phone: 808-779-5807
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY-2328
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: