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General NPI Number Information
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NPI Number | 1992291645
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Entity Type | Individual
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Provider Name | MAYA NATASSIA MATHEIS PHD
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Gender | Female
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Dates
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Enumeration Date | 07/05/2018
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Last Update Date | 12/05/2022
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Provider Practice Location Address
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Address Line | 1164 BISHOP ST STE 929
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City | HONOLULU
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State | HI
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Zip | 96813-2882
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Country | US
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Telephone | 808-556-7708
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 26401
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City | HONOLULU
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State | HI
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Zip | 96825-6401
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Country | US
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Telephone | 808-556-7708
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY1979
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License Number State | HI
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