Provider Demographics
NPI:1225130826
Name:HAMADA, ROGER SABURO (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROGER
Middle Name:SABURO
Last Name:HAMADA
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92-1248 KALEO PL
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-1535
Mailing Address - Country:US
Mailing Address - Phone:808-672-4865
Mailing Address - Fax:808-951-9282
Practice Address - Street 1:1833 KALAKAUA AVE
Practice Address - Street 2:SUITE 800
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815-1512
Practice Address - Country:US
Practice Address - Phone:808-946-6763
Practice Address - Fax:808-951-9282
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY372103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI005617-5Medicare UPIN