Provider Demographics
NPI:1265966964
Name:PSYCHIATRY GROUP HAWAII LTD
Entity type:Organization
Organization Name:PSYCHIATRY GROUP HAWAII LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STACY
Authorized Official - Middle Name:NOBUKO
Authorized Official - Last Name:UYEKUBO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-234-3421
Mailing Address - Street 1:2855 E MANOA RD
Mailing Address - Street 2:STE 105 #337
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96822-1854
Mailing Address - Country:US
Mailing Address - Phone:808-234-3421
Mailing Address - Fax:808-797-2422
Practice Address - Street 1:2855 E MANOA RD
Practice Address - Street 2:STE 105 #337
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96822-1854
Practice Address - Country:US
Practice Address - Phone:808-234-3421
Practice Address - Fax:808-797-2422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-19
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM0850X
HI14770261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health