MAVIS A MIZUMOTO (NPI# 1396895900) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396895900 |
| Entity Type | Individual |
| Full Name | MAVIS A MIZUMOTO |
| Credential | PH.D. |
| Practice Address |
1268 Young St Ste 200 Honolulu HI 96814-1801 |
| Mailing Address |
2603 Peter St Honolulu HI 96816-2013 |
| Practice Telephone | 8087352378 |
| Practice Fax Number | 8085978183 |
| Mailing Telephone | 8087352378 |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2017-01-30 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PSY-481 | HI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| HI | HMA | 192907 | 01 |
| HI | MDX | PSY481-01 | 01 |
| HI | SUMMERLIN | 192907 | 01 |
| HI | HMN | 192907 | 01 |
| HI | HMSA | C044590-8 | 01 |
| HI | UHC | PSY481-01 | 01 |
| HI | DESERT MUTUAL | PSY481-01 | 01 |
| HI | 040501-01 | 05 | |
| HI | AETNA | 0007919184 | 01 |
| HI | CIGNA | PSY481-01 | 01 |
| Street Address |
1268 YOUNG ST STE 200 |
| City | HONOLULU |
| State | HI |
| Zip Code | 96814-1801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437255676 | Lisa Lorene Hartwell-tindle | Psychologist | 1268 Young St, Suite 200, Honolulu, HI 96814-1801 | 2006-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336746478 | Ross Thomas Fujimori Pascual | Pharmacist | 750 Keeaumoku Street, Honolulu, HI 96814 | 2020-10-01 |
| 1336755263 | Hawaikikitelehealth LLC | Counselor | 1108 Auwahi Street, 1506, Honolulu, HI 96814 | 2020-09-16 |
| 1225647324 | Metaphysio Hawaii LLC | Physical Therapist | 1350 South King Street Suite 303, Honolulu, HI 96814 | 2020-07-24 |
| 1114572161 | Alyssa Foster | Social Worker | 1314 S King St Ste 1152, Honolulu, HI 96814 | 2019-08-07 |
| 1871157628 | Ala Moana Walk-in Medical Clinic, Inc | Nurse Practitioner | 410 Atkinson Dr., Level 3, Honolulu, HI 96814 | 2019-04-26 |
| 1528524014 | Regenerative Living Private Duty Inc | Home Health Aide | 1314 South King Street Ste 853, Honolulu, HI 96814 | 2019-02-20 |
| 1295299428 | Kaori Utashiro | Massage Therapist | 1450 Ala Moana Blvd. Suite1227, Honolulu, HI 96814 | 2019-01-22 |
| 1619444569 | Optimized Health LLC | General Practice | 1441 Kapiolani Blvd Ste 1114, #23464, Honolulu, HI 96814 | 2018-10-30 |
| 1356823785 | Tara Yamauchi-lum LLC | Marriage & Family Therapist | 615 Piikoi Street Suite 1109, Honolulu, HI 96814 | 2018-09-01 |
| 1992283980 | Sonia Q. Cosio, D.d.s | Dentist | 1441 Kapiolani Blvd #518, Honolulu, HI 96814 | 2018-08-01 |
| Find all providers in zip 96814 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992319008 | Rachel Huxel | Psychologist | 1821 Keeaumoku St Apt 201, Honolulu, HI 96822-3005 | 2020-09-04 |
| 1386256626 | Gabriela Cretu Cretu | Psychologist | 3820 Pukalani Pl, Honolulu, HI 96816-3816 | 2020-08-18 |
| 1427513563 | Hannah Im | Psychologist | 377 Keahole St Ste 210, Honolulu, HI 96825-3405 | 2019-02-03 |
| 1265928873 | Amy Humphrey | Psychologist | 615 Piikoi St Ste 1605, Honolulu, HI 96814-3142 | 2018-07-06 |
| 1346750338 | Nikita M Hay | Psychologist | 361 Hobron Ln, Honolulu, HI 96815-1039 | 2017-10-04 |
| 1346765336 | Vilmarie Baez | Psychologist | 1600 Kapiolani Blvd Ste 1340, Honolulu, HI 96814-3806 | 2017-08-10 |
| 1750815114 | Alex Bliss Walter | Psychologist | 1221 Kapiolani Blvd, Penthouse 38, Hawaii Psychology Collective, Honolulu, HI 96814 | 2017-04-12 |
| 1124567151 | Apostolis Amaxopoulos | Psychologist | 1608 Keeaumoku St, Honolulu, HI 96822-4310 | 2017-02-23 |
| 1700323763 | Istvan Kacso | Psychologist | 1415 Victoria St Apt 1103, Honolulu, HI 96822-3542 | 2017-01-27 |
| 1376085050 | Julie Yurie Takishima-lacasa | Psychologist | 850 W Hind Dr Ste 202, Honolulu, HI 96821-1845 | 2016-11-10 |
| 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.