1457431470 NPI number — DR. DALE T HIGASHINO PSY.D.

Table of content: DR. DALE T HIGASHINO PSY.D. (NPI 1457431470)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457431470 NPI number — DR. DALE T HIGASHINO PSY.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HIGASHINO
Provider First Name:
DALE
Provider Middle Name:
T
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PSY.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1457431470
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/08/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 25311
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HONOLULU
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96825-0311
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-497-7435
Provider Business Mailing Address Fax Number:
808-373-7972

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
98-211 PALI MOMI ST
Provider Second Line Business Practice Location Address:
SUITE 600
Provider Business Practice Location Address City Name:
AIEA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96701-4301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-497-7435
Provider Business Practice Location Address Fax Number:
808-373-7972
Provider Enumeration Date:
10/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  PSY-569 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00D0204976 . This is a "HMSA" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".




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