MEDICARE: DR. JAMES SLOBODZIEN PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	584	HI

General Provider Information

NPI Number	:	1750371670
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES SLOBODZIEN PSY.D.

Provider Business Mailing Address
First Line	:	1465 S KING ST
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96814-2510
Country	:	US
Telephone Number	:	808-255-4831
Fax Number	:

Provider Business Practice Location Address
First Line	:	1465 S KING ST APT 1
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96814-2510
Country	:	US
Telephone Number	:	808-255-4831
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/21/2005
Last Update Date	:	07/27/2011

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