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General NPI Number Information
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NPI Number | 1104500552
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Entity Type | Organization
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Legal Business Name | PACIFIC SHORES PSYCHOLOGY LLC
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Dates
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Enumeration Date | 06/14/2023
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Last Update Date | 06/14/2023
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Provider Practice Location Address
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Address Line | 401 KAMAKEE ST SUITE #405
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City | HONOLULU
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State | HI
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Zip | 96814
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Country | US
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Telephone | 808-444-5944
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Fax |
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Provider Business Mailing Address
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Address Line | 1441 KAPIOLANI BLVD STE 1114 UNIT 79599
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City | HONOLULU
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State | HI
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Zip | 96814-4406
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Country | US
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Telephone | 808-444-5944
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. CHRISTINE ROLLINS HERNANDEZ
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Credential | PSYD
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Telephone | 808-444-5944
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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