Provider Demographics
NPI:1356393235
Name:AMERSON, EFLAND H (PSYD)
Entity type:Individual
Prefix:DR
First Name:EFLAND
Middle Name:H
Last Name:AMERSON
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1188 BISHOP ST STE 2512
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-3310
Mailing Address - Country:US
Mailing Address - Phone:808-450-9825
Mailing Address - Fax:808-200-7711
Practice Address - Street 1:1188 BISHOP ST STE 2512
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-3310
Practice Address - Country:US
Practice Address - Phone:808-450-8925
Practice Address - Fax:808-200-7711
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY-940390200000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000259424OtherHMSA BILLING NUMBER
HI58061403Medicaid
HIH101791Medicare PIN