Healthcare Provider Details

I. General information

NPI: 1508923772
Provider Name (Legal Business Name): AGNES FELIX PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 03/21/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94-210 PUPUKAHI ST STE 207
WAIPAHU HI
96797-2649
US

IV. Provider business mailing address

PO BOX 2224
EWA BEACH HI
96706-0224
US

V. Phone/Fax

Practice location:
  • Phone: 808-382-6816
  • Fax:
Mailing address:
  • Phone: 808-382-6816
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY12604
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY-883
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: