Provider Demographics
NPI:1346497500
Name:MOSS, KATRINA PERREIRA (PSYD)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:PERREIRA
Last Name:MOSS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:KATRINA
Other - Middle Name:LOUISE
Other - Last Name:MOSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFT
Mailing Address - Street 1:462 KAHINU ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96821-2217
Mailing Address - Country:US
Mailing Address - Phone:808-226-9110
Mailing Address - Fax:
Practice Address - Street 1:462 KAHINU ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96821-2217
Practice Address - Country:US
Practice Address - Phone:808-226-9110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-19
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist