| Gina Leong Samala, Psy.d, Inc. | |
|
95-1249 Meheula Pkwy Suite B30 Unit 195 Mililani HI 96789-1779 | |
| (808) 625-7448 | |
| (808) 625-7448 |
| Full Name | Gina Leong Samala, Psy.d, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 95-1249 Meheula Pkwy, Mililani, Hawaii |
| Authorized Official Name and Position | Gina Leong Samala (PRESIDENT) |
| Authorized Official Contact | 8086257448 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gina Leong Samala, Psy.d, Inc. 85-979 Farrington Hwy Ste C Waianae HI 96792-2678 Ph: (808) 625-7448 | Gina Leong Samala, Psy.d, Inc. 95-1249 Meheula Pkwy Suite B30 Unit 195 Mililani HI 96789-1779 Ph: (808) 625-7448 |
| NPI Number | 1255517652 |
|---|---|
| Provider Enumeration Date | 01/15/2008 |
| Last Update Date | 01/15/2008 |
| Medicare PECOS PAC ID | 1153303912 |
|---|---|
| Medicare Enrollment ID | O20040604000319 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255517652 | NPI | - | NPPES |
| 56756301 | Medicaid | HI | |
| H56631 | Other | HI | MEDICARE INDIVIDUAL PIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY-756 (Hawaii) | Primary |
| Provider Name | Gina Al Samala |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1386869691 PECOS PAC ID: 4587646203 Enrollment ID: I20040621000461 |
| Provider Name | Michelle Marie Kawasaki |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1932568367 PECOS PAC ID: 3476858093 Enrollment ID: I20160219000493 |
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