Healthcare Provider Details

I. General information

NPI: 1528505013
Provider Name (Legal Business Name): PACIFIC BEHAVIORAL HEALTH LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2017
Last Update Date: 01/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

970 N KALAHEO AVE STE A314
KAILUA HI
96734-1870
US

IV. Provider business mailing address

PO BOX 247
KAILUA HI
96734-0247
US

V. Phone/Fax

Practice location:
  • Phone: 808-225-2193
  • Fax: 888-604-2131
Mailing address:
  • Phone: 808-225-2193
  • Fax: 888-604-2131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY1332
License Number StateHI

VIII. Authorized Official

Name: DR. JAMES LIONEL SPIRA
Title or Position: OWNER
Credential: PHD, MPH, ABPP
Phone: 808-225-2193