Healthcare Provider Details

I. General information

NPI: 1750537460
Provider Name (Legal Business Name): MARK RAUSER PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2008
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 S KIHEI RD STE 218
KIHEI HI
96753-8145
US

IV. Provider business mailing address

65 WAIAPO ST
KIHEI HI
96753-7356
US

V. Phone/Fax

Practice location:
  • Phone: 808-818-3588
  • Fax:
Mailing address:
  • Phone: 773-301-6144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number071.007218
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: