Provider Demographics
NPI:1003146374
Name:VAL J UMPHRESS PHD LLC
Entity Type:Organization
Organization Name:VAL J UMPHRESS PHD LLC
Other - Org Name:VAL J. UMPHRESS, PH.D., LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:VAL
Authorized Official - Middle Name:J
Authorized Official - Last Name:UMPHRESS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:808-372-8572
Mailing Address - Street 1:98-211 PALI MOMI ST
Mailing Address - Street 2:SUITE 810
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-4301
Mailing Address - Country:US
Mailing Address - Phone:808-488-9288
Mailing Address - Fax:808-488-9288
Practice Address - Street 1:98-211 PALI MOMI ST
Practice Address - Street 2:SUITE 810
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-4301
Practice Address - Country:US
Practice Address - Phone:808-488-9288
Practice Address - Fax:808-488-9288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-07
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY-611103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty