Provider Demographics
NPI:1518341361
Name:PACIFIC PSYCHOLOGY PARTNERS, INC.
Entity Type:Organization
Organization Name:PACIFIC PSYCHOLOGY PARTNERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANXDER
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:BIVENS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:808-332-7190
Mailing Address - Street 1:PO BOX 321
Mailing Address - Street 2:
Mailing Address - City:ANAHOLA
Mailing Address - State:HI
Mailing Address - Zip Code:96703-0321
Mailing Address - Country:US
Mailing Address - Phone:808-332-7190
Mailing Address - Fax:
Practice Address - Street 1:2975 HALEKO RD STE 307
Practice Address - Street 2:
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-1366
Practice Address - Country:US
Practice Address - Phone:808-332-7190
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-11
Last Update Date:2015-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI743103T00000X
HI702103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty