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General NPI Number Information
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NPI Number | 1770636581
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Entity Type | Individual
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Provider Name | PRATIBHA SHULAMIT EASTWOOD PH.D.
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Gender | Female
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 1016 KAPAHULU AVE STE 265
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City | HONOLULU
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State | HI
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Zip | 96816-1318
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Country | US
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Telephone | 808-214-9253
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2022
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City | WHITE CITY
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State | OR
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Zip | 97503-0022
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Country | US
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Telephone | 541-234-4781
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Fax |
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY390
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License Number State | HI
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