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General NPI Number Information
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NPI Number | 1548360167
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Entity Type | Individual
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Provider Name | WARREN ROSS LOOS PH.D.
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Gender | Male
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Dates
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Enumeration Date | 09/24/2006
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Last Update Date | 07/26/2022
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Provider Practice Location Address
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Address Line | 4300 WAIALAE AVE APT B1002
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City | HONOLULU
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State | HI
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Zip | 96816-5757
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Country | US
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Telephone | 808-284-2200
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Fax | 888-668-8527
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Provider Business Mailing Address
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Address Line | 4348 WAIALAE AVE # 403
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City | HONOLULU
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State | HI
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Zip | 96816-5767
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Country | US
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Telephone | 808-284-2200
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Fax | 888-668-8527
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | PSY-792
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License Number State | HI
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