KAHALA CLINIC LLC (NPI# 1053666842) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053666842 |
| Entity Type | Organization |
| Organization Name | KAHALA CLINIC LLC |
| Practice Address |
4211 Waialae Ave Suite 207 Honolulu HI 96816-5319 |
| Practice Telephone | 8085427349 |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2012-07-17 |
| Authorized Official Name | JASON RICHARD KEIFER (OWNER) |
| Authorized Official Telephone | 8085427349 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
MD12987 | HI | Allopathic & Osteopathic Physicians |
| Street Address |
4211 WAIALAE AVE SUITE 207 |
| City | HONOLULU |
| State | HI |
| Zip Code | 96816-5319 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962457317 | Sheri Sloggett Shanks | Psychologist | 4211 Waialae Ave, Suite 206a, Honolulu, HI 96816-5319 | 2006-05-24 |
| 1699301408 | Elizabeth A Pavlik | Nurse Practitioner | 4211 Waialae Ave, Honolulu, HI 96816-5319 | 2020-03-13 |
| 1902366099 | Grisel M Reyes-dennis | Nurse Practitioner | 4211 Waialae Ave, Honolulu, HI 96816-5319 | 2019-03-23 |
| 1891285664 | Marchael T Andres | Massage Therapist | 4211 Waialae Ave, Honolulu, HI 96816-5319 | 2018-05-16 |
| 1134621352 | Glenn Morikawa | Pharmacist | 4211 Waialae Ave, Honolulu, HI 96816-5319 | 2018-03-03 |
| 1710488606 | Kenna Muramoto | Pharmacist | 4211 Waialae Ave, Honolulu, HI 96816-5319 | 2018-02-26 |
| 1972001337 | Angelica Hong | Pharmacist | 4211 Waialae Ave, Honolulu, HI 96816-5319 | 2018-01-31 |
| 1750821278 | Cassie Robinson | Massage Therapist | 4211 Waialae Ave, Honolulu, HI 96816-5319 | 2017-03-02 |
| 1417402082 | Jamie Mizusawa | Pharmacist | 4211 Waialae Ave, Honolulu, HI 96816-5319 | 2016-08-24 |
| 1588012884 | Nadalin Inc | Massage Therapist | 4211 Waialae Ave, Honolulu, HI 96816-5319 | 2016-05-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598370439 | Marina Nogues | Nurse Practitioner | 3901b Maunahilu Pl, Honolulu, HI 96816 | 2020-09-08 |
| 1184272007 | Gwen Mikasa | Speech-Language Pathologist | Office of Student Support Medicaid Reimbursement, 475 22nd Ave, Bldg 302, Room 101, Honolulu, HI 96816 | 2019-09-04 |
| 1467009290 | Abigail Hobbs | Occupational Therapist | 475 22nd Ave, Building 302, Rm. 101, Oss, Honolulu, HI 96816 | 2019-08-26 |
| 1588210587 | Mona Ann Hiyoto Akina | Speech-Language Pathologist | 475 2nd Ave., Room 127, Honolulu, HI 96816 | 2019-08-15 |
| 1356996599 | Karen Amanda Kama | Speech-Language Pathologist | Office of Student Support Services, 475 22nd Avenue Room 101, Honolulu, HI 96816 | 2019-08-05 |
| 1043864630 | Brittni Holt | Speech-Language Pathologist | 475 22nd Ave Building 302 Room 101, Honoluu, HI 96816 | 2019-07-31 |
| 1376197962 | Mallory Register | Speech-Language Pathologist | 475 22nd Avenue, Building 302, Room 101, Honolulu, HI 96816 | 2019-07-31 |
| 1588144935 | Mihoko Yacavone | Dietitian, Registered | 833 15th Ave, Honolulu, HI 96816 | 2018-08-15 |
| 1760976013 | Orthopaedic Specialists Hawaii LLC | Orthopaedic Surgery | 4348 Waialae Ave, Suite 479, Honolulu, HI 96816 | 2018-06-20 |
| 1790207389 | Richard Todd Robbins Jr. | Behavior Technician | 200 N. Vineyard Blvd. Suite A-600, Honolulu, HI 96816 | 2017-07-14 |
| Find all providers in zip 96816 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205459492 | Outcomes Clinic LLC | Psychiatry & Neurology | 243 N Judd St Apt C, Honolulu, HI 96817-1747 | 2020-05-21 |
| 1932564861 | Kahala Clinic for Children & Family Inc | Psychiatry & Neurology | 4211 Waialae Ave Ste 207, Honolulu, HI 96816-5312 | 2015-12-18 |
| 1982876371 | Alayne Yates | Psychiatry & Neurology | 242 Opihikao Way, Honolulu, HI 96825 | 2008-03-26 |
| 1831398148 | Josephine Pardenilla Horita | Psychiatry & Neurology | 4211 Waialae Ave Ste 208, Honolulu, HI 96816-5312 | 2007-07-16 |
| 1548488570 | Lili Kelly | Psychiatry & Neurology | 320 Ohua Ave, Ste 802, Honolulu, HI 96815-3670 | 2007-04-23 |
| 1851456297 | Eberhard Martin Mann | Psychiatry & Neurology | 1650 Kanunu St Ph 1, Honolulu, HI 96814-2743 | 2006-12-26 |
| 1275770752 | Mind & Body Works, Inc. | Psychiatry & Neurology | 3340 Wauke St, Honolulu, HI 96815-4452 | 2009-01-20 |
| 1699978783 | Judith M Steel | Psychiatry & Neurology | 1356 Lusitana St, 4th Floor, Honolulu, HI 96813-2421 | 2007-06-07 |
| 1184833022 | Tina Rae Melendrez-chu | Psychiatry & Neurology | 1441 Kapiolani Blvd Fl 16, Honolulu, HI 96814-4402 | 2007-05-21 |
| 1013123918 | Daniel A. Alicata | Psychiatry & Neurology | 1356 Lusitana St, 4th Floor, Honolulu, HI 96813-2421 | 2007-05-15 |
| Find all providers in HONOLULU | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.