Provider Demographics
NPI:1831419555
Name:LI, CHUN-I (PHD)
Entity type:Individual
Prefix:
First Name:CHUN-I
Middle Name:
Last Name:LI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:JEANIE
Other - Middle Name:
Other - Last Name:LI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:PO BOX 1723
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-8723
Mailing Address - Country:US
Mailing Address - Phone:808-419-7832
Mailing Address - Fax:808-468-4869
Practice Address - Street 1:47-692 HUI ULILI ST
Practice Address - Street 2:
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-4662
Practice Address - Country:US
Practice Address - Phone:808-419-7832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-03
Last Update Date:2025-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1451103T00000X, 103TC0700X
CAPSY26106103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical