Provider Demographics
NPI:1184138943
Name:ROGER S. HAMADA, PH.D., INC.
Entity type:Organization
Organization Name:ROGER S. HAMADA, PH.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:SABURO
Authorized Official - Last Name:HAMADA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:808-488-7001
Mailing Address - Street 1:92-1248 KALEO PL
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-1535
Mailing Address - Country:US
Mailing Address - Phone:808-753-7148
Mailing Address - Fax:
Practice Address - Street 1:98-211 PALI MOMI ST STE 810
Practice Address - Street 2:
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-4377
Practice Address - Country:US
Practice Address - Phone:808-488-7001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-30
Last Update Date:2017-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY-372103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty