DR. CP KELLY BASS (NPI# 1457423352) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457423352 |
| Entity Type | Individual |
| Full Name | DR. CP KELLY BASS |
| Credential | PHD |
| Practice Address |
1129 E Main St 305 Wailuku HI 96793-2053 |
| Practice Telephone | 8082427011 |
| Practice Fax Number | 8082449010 |
| Mailing Telephone | 8082427011 |
| Mailing Fax Number | 8082449010 |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2012-12-05 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
292 | HI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| HI | MEDICARE PTAN | H0000TCBHB | 01 |
| HI | HMAA | 000077 | 01 |
| HI | 01542101 | 05 |
| Street Address |
1129 E MAIN ST 305 |
| City | WAILUKU |
| State | HI |
| Zip Code | 96793-2053 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699384701 | Laura Covey | Massage Therapist | Wailuku Community Acupuncture, 33 Central Ave, Wailuku, HI 96793 | 2020-07-24 |
| 1750902839 | Massage Therapy and Wellness of Hawai, LLC | Massage Therapist | Massage Therapy and Wellness of Hawaii, 219 Hookahi St Suite 108, Wailuku, HI 96793 | 2020-04-30 |
| 1790329084 | Milba Rojas Melchor | Technician | 932 Wailupe Drive, Wailuku, HI 96793 | 2019-10-30 |
| 1669973863 | Chad Adolpho | Massage Therapist | 95 Mahalani Street, Room 21, Wailuku, HI 96793 | 2018-02-22 |
| 1548785520 | Hookaulike Wellness LLC | Registered Nurse | 720 Kealii Drive, Wailuku, HI 96793 | 2017-08-10 |
| 1932585072 | Back & Body Clinic of Hi, LLC | Massage Therapist | 81 Central Avenue, Wailuku, HI 96793 | 2015-07-30 |
| 1558765719 | Maui Cancer Clinic, Inc. | Clinic/Center | 24 North Church Street Suite 308, Wailuku, HI 96793 | 2014-10-17 |
| 1609275262 | Maui Memorial Medical Center | General Acute Care Hospital | 85 Maui Lani Parkway, Wailuku, HI 96793 | 2014-08-20 |
| 1558780072 | Mental Health Kokua | Community/Behavioral Health | 503 -a Ua Place, Wailuku, HI 96793 | 2014-04-11 |
| 1538584545 | Mental Health Kokua | Assisted Living Facility | 503 Ua Pl, Iao Valley, Wailuku, Maui, HI 96793 | 2014-02-27 |
| Find all providers in zip 96793 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790993541 | Ince Health and Wellness, LLC | Psychologist | 736 Kakalina Place, Wailuku, HI 96793 | 2007-05-17 |
| 1114045655 | Deanna Mirzai-nagasaka | Psychologist | 1939 E Vineyard St, Wailuku, HI 96793-1714 | 2007-03-26 |
| 1548366636 | Susan Frieder | Psychologist | 2200 Main St Ste 510, Wailuku, HI 96793-1624 | 2006-09-15 |
| 1720453640 | Daniel Nead | Psychologist | 1881 Nani St, Wailuku, HI 96793-1811 | 2015-12-03 |
| 1518342567 | Alisha Yoshitsugu | Psychologist | 1881 Nani St, Wailuku, HI 96793-1811 | 2015-07-20 |
| 1811398357 | Jillian Freitas | Psychologist | 95 Mahalani St Rm 21, Wailuku, HI 96793-2521 | 2014-09-15 |
| 1356577415 | Thomas Tsung-ping Chen | Psychologist | 2200 Main St, Suite #519, Wailuku, HI 96793-1681 | 2009-06-03 |
| 1679748388 | Giulietta C Swenson | Psychologist | 270 Waiehu Beach Rd, Suite 215, Wailuku, HI 96793-1472 | 2008-04-23 |
| 1477698850 | Wendy Hanada Choi | Psychologist | 1885 Main St, Suite 207, Wailuku, HI 96793 | 2007-02-21 |
| 1710022199 | George Chi Choi | Psychologist | 1885 Main St, Suite 207, Wailuku, HI 96793 | 2007-02-21 |
| Find all providers in WAILUKU | ||||
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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.