Healthcare Provider Details

I. General information

NPI: 1912498551
Provider Name (Legal Business Name): CAROLINE ROSE KEALANI RITSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2018
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

354 ULUNIU ST STE 404A
KAILUA HI
96734-2533
US

IV. Provider business mailing address

354 ULUNIU ST STE 404A
KAILUA HI
96734-2533
US

V. Phone/Fax

Practice location:
  • Phone: 802-432-8863
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number22262
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: