Provider Demographics
NPI:1871251488
Name:DEVON MASUDA, PSY D LLC
Entity Type:Organization
Organization Name:DEVON MASUDA, PSY D LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEVON
Authorized Official - Middle Name:
Authorized Official - Last Name:MASUDA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:808-825-8275
Mailing Address - Street 1:PO BOX 7685
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-8949
Mailing Address - Country:US
Mailing Address - Phone:808-825-8275
Mailing Address - Fax:844-807-9181
Practice Address - Street 1:820 HELE MAUNA ST
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-1752
Practice Address - Country:US
Practice Address - Phone:808-825-8275
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-01
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI487755OtherWELLCARE
HI943282172OtherTRICARE
HI00E0265040OtherHMSA
HI590720Medicaid