Provider Demographics
NPI:1265418511
Name:JAMES, LARRY CHARLES (PHD)
Entity type:Individual
Prefix:DR
First Name:LARRY
Middle Name:CHARLES
Last Name:JAMES
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:95-1056 MAHELU ST
Mailing Address - Street 2:
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-6588
Mailing Address - Country:US
Mailing Address - Phone:808-433-2288
Mailing Address - Fax:808-433-1466
Practice Address - Street 1:1 JARRETT WHITE RD
Practice Address - Street 2:
Practice Address - City:TRIPLER AMC
Practice Address - State:HI
Practice Address - Zip Code:96859-5001
Practice Address - Country:US
Practice Address - Phone:808-433-2288
Practice Address - Fax:808-433-1466
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2009-04-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA616103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service