Provider Demographics
NPI:1134214554
Name:KHOURY, KRISTIN A (PSYD)
Entity type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:A
Last Name:KHOURY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:KRISTIN
Other - Middle Name:A
Other - Last Name:CHRISTENSEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:7192 KALANIANAOLE HIGHWAY
Mailing Address - Street 2:STE 143A #259
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96825
Mailing Address - Country:US
Mailing Address - Phone:808-384-4725
Mailing Address - Fax:808-888-4227
Practice Address - Street 1:7192 KALANIANAOLE HIGHWAY
Practice Address - Street 2:STE 143A #259
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96825
Practice Address - Country:US
Practice Address - Phone:808-384-4725
Practice Address - Fax:808-888-4227
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY 944103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00D0259939OtherHMSA KANEOHE
HI58543201OtherALOHACARE
HI685023OtherMILITARY ONE SOURCE
HIPSY944OtherMDX
HI00419117OtherUNITED HEALTH ALLIANCE