| Lisa A.k. Kaneshiro, Psyd, Llc | |
|
1266 Kamehameha Av Suite B Hilo HI 96720 | |
| (808) 933-1313 | |
| Not Available |
| Full Name | Lisa A.k. Kaneshiro, Psyd, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1266 Kamehameha Av, Hilo, Hawaii |
| Authorized Official Name and Position | Lisa A.k. Kaneshiro (SOLE MEMBER) |
| Authorized Official Contact | 8089331313 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa A.k. Kaneshiro, Psyd, Llc 1266 Kamehameha Avenue Suite B Hilo HI 96720 Ph: (808) 933-1313 | Lisa A.k. Kaneshiro, Psyd, Llc 1266 Kamehameha Av Suite B Hilo HI 96720 Ph: (808) 933-1313 |
| NPI Number | 1538341052 |
|---|---|
| Provider Enumeration Date | 11/27/2007 |
| Last Update Date | 11/27/2007 |
| Medicare PECOS PAC ID | 7618050410 |
|---|---|
| Medicare Enrollment ID | O20080218000341 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538341052 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY-848 (Hawaii) | Primary |
| Provider Name | Lisa A.k. Kaneshiro |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1134177785 PECOS PAC ID: 8325068521 Enrollment ID: I20080218000328 |
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