Provider Demographics
NPI:1548581648
Name:DERAMUS, LINDA L (PHD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:L
Last Name:DERAMUS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 WAIEHU BEACH RD
Mailing Address - Street 2:SUITE 213
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-1472
Mailing Address - Country:US
Mailing Address - Phone:808-243-1264
Mailing Address - Fax:
Practice Address - Street 1:270 WAIEHU BEACH RD
Practice Address - Street 2:SUITE 213
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-1472
Practice Address - Country:US
Practice Address - Phone:808-243-1264
Practice Address - Fax:808-243-1254
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-13
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist