Healthcare Provider Details

I. General information

NPI: 1568745172
Provider Name (Legal Business Name): JESSICA HIGA PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2011
Last Update Date: 08/01/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4-1101 KUHIO HWY UNIT 596
KAPAA HI
96746-4624
US

IV. Provider business mailing address

PO BOX 596
KAPAA HI
96746-0596
US

V. Phone/Fax

Practice location:
  • Phone: 808-386-2625
  • Fax:
Mailing address:
  • Phone: 808-386-2625
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number2249
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: