Healthcare Provider Details

I. General information

NPI: 1902894140
Provider Name (Legal Business Name): JANE S.R. FISHER PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2005
Last Update Date: 04/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1188 BISHOP ST SUITE 2302
HONOLULU HI
96813-3301
US

IV. Provider business mailing address

1188 BISHOP ST SUITE 2302
HONOLULU HI
96813-3301
US

V. Phone/Fax

Practice location:
  • Phone: 808-524-3398
  • Fax: 808-524-3398
Mailing address:
  • Phone: 808-524-3398
  • Fax: 808-524-3398

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY-493
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: