Provider Demographics
NPI:1356577415
Name:CHEN, THOMAS TSUNG-PING (PSYD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:TSUNG-PING
Last Name:CHEN
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 1:135 KULAMANU CIR
Mailing Address - Street 2:
Mailing Address - City:KULA
Mailing Address - State:HI
Mailing Address - Zip Code:96790-8281
Mailing Address - Country:US
Mailing Address - Phone:808-205-4489
Mailing Address - Fax:
Practice Address - Street 1:2200 MAIN ST
Practice Address - Street 2:SUITE #519
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-1681
Practice Address - Country:US
Practice Address - Phone:808-205-4489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-03
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY17965103TC0700X
HI1352103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical