Healthcare Provider Details

I. General information

NPI: 1518042506
Provider Name (Legal Business Name): GEORGE JAY FRIEDMAN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 11/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 N MARKET ST STE 205
WAILUKU HI
96793-1742
US

IV. Provider business mailing address

PO BOX 772
KULA HI
96790-0772
US

V. Phone/Fax

Practice location:
  • Phone: 808-244-5500
  • Fax: 866-288-7900
Mailing address:
  • Phone: 808-244-5500
  • Fax: 866-288-7900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License NumberPSY-371
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberPSY-371
License Number StateHI
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY-371
License Number StateHI
# 4
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPSY-371
License Number StateHI
# 5
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License NumberPSY-371
License Number StateHI
# 6
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY-371
License Number StateHI
# 7
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License NumberPSY-371
License Number StateHI
# 8
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License NumberPSY-371
License Number StateHI
# 9
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberPSY-371
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: