Healthcare Provider Details

I. General information

NPI: 1215982616
Provider Name (Legal Business Name): JEFFREY WINSTON CUMES PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 07/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81-6587 MAMALAHOA HWY BLDG C #23
KEALAKEKUA HI
96750-8133
US

IV. Provider business mailing address

PO BOX 1323
KEALAKEKUA HI
96750-1323
US

V. Phone/Fax

Practice location:
  • Phone: 808-323-9510
  • Fax: 808-323-9703
Mailing address:
  • Phone: 808-323-9510
  • Fax: 808-323-9703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY388
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: