Provider Demographics
NPI:1083942577
Name:KHOLOOCI, HEIKE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:HEIKE
Middle Name:
Last Name:KHOLOOCI
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 1:140 UWAPO RD APT 36-201
Mailing Address - Street 2:
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-7440
Mailing Address - Country:US
Mailing Address - Phone:808-830-6550
Mailing Address - Fax:
Practice Address - Street 1:140 UWAPO RD APT 36-201
Practice Address - Street 2:
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-7440
Practice Address - Country:US
Practice Address - Phone:808-830-6550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-23
Last Update Date:2023-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 23131103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical