Healthcare Provider Details

I. General information

NPI: 1235866534
Provider Name (Legal Business Name): CA PSYCHOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2022
Last Update Date: 08/05/2022
Certification Date: 08/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 HOBRON LN APT 1810
HONOLULU HI
96815-1213
US

IV. Provider business mailing address

PO BOX 8272
HONOLULU HI
96830-0272
US

V. Phone/Fax

Practice location:
  • Phone: 808-566-5636
  • Fax:
Mailing address:
  • Phone: 808-566-5636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. CATHERINE GALLAHUE
Title or Position: CLINICAL PSYCHOLOGIST
Credential: PSY.D.
Phone: 808-566-5636