Provider Demographics
NPI:1598930372
Name:BEYER CAVACO, KAPUALEINANI (PSYD)
Entity Type:Individual
Prefix:
First Name:KAPUALEINANI
Middle Name:
Last Name:BEYER CAVACO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2394 E MANOA RD
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96822-1938
Mailing Address - Country:US
Mailing Address - Phone:808-343-7173
Mailing Address - Fax:
Practice Address - Street 1:4348 WAIALAE AVE # 625
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-5767
Practice Address - Country:US
Practice Address - Phone:808-798-6792
Practice Address - Fax:808-356-1509
Is Sole Proprietor?:No
Enumeration Date:2008-04-23
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY-1707103TC0700X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI822446Medicaid