Healthcare Provider Details

I. General information

NPI: 1619171899
Provider Name (Legal Business Name): ALOHA PSYCHOLOGICAL SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2007
Last Update Date: 07/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N BERETANIA ST SUITE 208
HONOLULU HI
96817-4712
US

IV. Provider business mailing address

1255 NUUANU AVE 2201
HONOLULU HI
96817-4017
US

V. Phone/Fax

Practice location:
  • Phone: 808-591-2345
  • Fax:
Mailing address:
  • Phone: 808-591-2345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170100000X
TaxonomyPh.D. Medical Genetics
License NumberPSY 324
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberACU 799
License Number StateHI

VIII. Authorized Official

Name: CRAIG T TWENTYMAN
Title or Position: DR.
Credential: PH.D.
Phone: 808-591-2345