Provider Demographics
NPI:1033726534
Name:NISHIHIRA, JULIE H (PSYD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:H
Last Name:NISHIHIRA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 N KUKUI ST APT 2711
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-4161
Mailing Address - Country:US
Mailing Address - Phone:808-206-2671
Mailing Address - Fax:
Practice Address - Street 1:1164 BISHOP ST STE 929
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2882
Practice Address - Country:US
Practice Address - Phone:808-308-5226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-28
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY-1795103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical