Provider Demographics
NPI:1487685251
Name:LOVETTE, BRENDA (PSY D)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:
Last Name:LOVETTE
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1467 KIUKEE PL
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-4271
Mailing Address - Country:US
Mailing Address - Phone:808-222-1414
Mailing Address - Fax:
Practice Address - Street 1:1467 KIUKEE PL
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-4271
Practice Address - Country:US
Practice Address - Phone:808-223-7171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY708103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI49720702Medicaid
HI00A0227676OtherHAWAII MEDICAL SVC ASSN
HI49720702Medicaid