Provider Demographics
NPI:1154311850
Name:EDMONDS, BRENDA H (PSYD)
Entity Type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:H
Last Name:EDMONDS
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 1:5333 LIKINI ST
Mailing Address - Street 2:#109
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96818-1762
Mailing Address - Country:US
Mailing Address - Phone:808-833-7791
Mailing Address - Fax:
Practice Address - Street 1:1 JARRETT WHITE ROAD TRIPLER ARMY MEDICAL CENTER
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96857-5000
Practice Address - Country:US
Practice Address - Phone:808-433-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY-830103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical