| Gova Llc | |
|
3310 Tantalus Dr Honolulu HI 96822-5011 | |
| (808) 352-5050 | |
| Not Available |
| Full Name | Gova Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3310 Tantalus Dr, Honolulu, Hawaii |
| Authorized Official Name and Position | Claude Anthony Goins (MEMBER/ORGANIZER) |
| Authorized Official Contact | 8083525050 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gova Llc 3310 Tantalus Dr Honolulu HI 96822-5011 Ph: (808) 352-5050 | Gova Llc 3310 Tantalus Dr Honolulu HI 96822-5011 Ph: (808) 352-5050 |
| NPI Number | 1750674990 |
|---|---|
| Provider Enumeration Date | 05/20/2011 |
| Last Update Date | 10/29/2012 |
| Medicare PECOS PAC ID | 1557500048 |
|---|---|
| Medicare Enrollment ID | O20130612000708 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750674990 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Lindsey M King |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003263237 PECOS PAC ID: 3476843384 Enrollment ID: I20160606001771 |
| Provider Name | Amy Lynn Humphrey |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1265928873 PECOS PAC ID: 6002150638 Enrollment ID: I20181207001224 |
| Provider Name | June Louise Hurst-jones |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093137382 PECOS PAC ID: 2860777869 Enrollment ID: I20190418001894 |
| Provider Name | Gabrielle D Toloza |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063969897 PECOS PAC ID: 3870913056 Enrollment ID: I20201009001782 |
| Provider Name | Paula Daryanani |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1083366652 PECOS PAC ID: 4486048782 Enrollment ID: I20220302002952 |
| Provider Name | Alistair G Taylor |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1013531250 PECOS PAC ID: 8729451034 Enrollment ID: I20230308001016 |
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