Provider Demographics
NPI:1689727802
Name:BERKLINE, RAND R (PSY D)
Entity Type:Individual
Prefix:DR
First Name:RAND
Middle Name:R
Last Name:BERKLINE
Suffix:
Gender:M
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 1:47-720 HUI KELU ST
Mailing Address - Street 2:SUITE 7
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-4510
Mailing Address - Country:US
Mailing Address - Phone:808-239-1244
Mailing Address - Fax:808-239-1244
Practice Address - Street 1:970 N KALAHEO AVE
Practice Address - Street 2:SUITE A-218
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-1801
Practice Address - Country:US
Practice Address - Phone:808-239-1244
Practice Address - Fax:808-239-1244
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY-613103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent