KA IMI PONO, LLC (NPI# 1083891469) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083891469 |
| Entity Type | Organization |
| Organization Name | KA IMI PONO, LLC |
| Practice Address |
1029 Kapahulu Ave Ste 405 Honolulu HI 96816-1332 |
| Mailing Address |
Po Box 161191 Honolulu HI 96816-0925 |
| Practice Telephone | 8083875307 |
| Practice Fax Number | 8082187884 |
| Mailing Telephone | 8083875307 |
| Mailing Fax Number | 8082187884 |
| Enumeration Date | 2008-01-28 |
| Last Update Date | 2008-01-28 |
| Authorized Official Name | DR. GAIL LYNN TICE (CLINICAL PSYCHOLOGIST) |
| Authorized Official Telephone | 8083875307 |
| Authorized Official Credential | PSY.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
899 | HI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| HI | PERSONAL NPI | 1225133481 | 01 |
| Street Address |
1029 KAPAHULU AVE STE 405 |
| City | HONOLULU |
| State | HI |
| Zip Code | 96816-1332 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588292759 | Koemi Wellness, LLC | Psychologist | 1029 Kapahulu Ave Ste 405, Honolulu, HI 96816-1332 | 2020-03-31 |
| 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 | 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.