Provider Demographics
NPI:1235421926
Name:SANDEFUR, ROBYN MAHANA (PSY D)
Entity Type:Individual
Prefix:MRS
First Name:ROBYN
Middle Name:MAHANA
Last Name:SANDEFUR
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:MS
Other - First Name:ROBYN
Other - Middle Name:MAHANA
Other - Last Name:CHANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSY D
Mailing Address - Street 1:401 KAMAKE'E STREET
Mailing Address - Street 2:SUITE 409
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814
Mailing Address - Country:US
Mailing Address - Phone:808-729-7698
Mailing Address - Fax:866-313-3630
Practice Address - Street 1:401 KAMAKEE STREET
Practice Address - Street 2:SUITE 409
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814
Practice Address - Country:US
Practice Address - Phone:808-729-7698
Practice Address - Fax:866-313-3630
Is Sole Proprietor?:No
Enumeration Date:2011-05-12
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY-1255103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical