MEDICARE: DR. JORDANA HABEEB HAZAM 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	PSY-1888	HI

General Provider Information

NPI Number	:	1851793665
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JORDANA HABEEB HAZAM PSY.D.

Provider Business Mailing Address
First Line	:	758 KAPAHULU AVE STE 100
Second Line	:	#979
City	:	HONOLULU
State	:	HI
Zip	:	96816-6099
Country	:	US
Telephone Number	:	808-378-7633
Fax Number	:

Provider Business Practice Location Address
First Line	:	98-030 HEKAHA ST STE 23
Second Line	:
City	:	AIEA
State	:	HI
Zip	:	96701-4911
Country	:	US
Telephone Number	:	808-378-7633
Fax Number	:

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

Provider Enumeration Date	:	09/24/2014
Last Update Date	:	02/06/2026

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