Individual provider Active NPI

Gina Lyn Cheryl Aya Camara, PSY.D.

  • Clinical Psychologist
  • Honolulu, HI
National Provider Identifier
1003147547
Registry record updated Jan 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY-1092 Issued in HI
Practice address
1188 Bishop Street
Suite 3206
Honolulu, HI 96813
Phone
(808) 783-9245
NPI assigned
Jan 22, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY-1092 HI
Clinical Psychologist 103TC0700X PSY-1092 HI Primary

Addresses

Primary practice location

1188 Bishop Street
Suite 3206
Honolulu, HI 96813

Mailing address

350 Aoloa Street
A210
Kailua, HI 96734
Phone (808) 783-9245

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240904002585 HI Practitioner - Clinical Psychologist 6305386442 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Manakai O Malama IntegrativeGroup PAC ID 4880582808, 9 clinicians

Practice addresses (Care Compare)

677 Ala Moana Blvd
SPC 950
Honolulu, HI 96813-5408
Phone (808) 535-5555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY-1092HIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Manakai O Malama Integrative CurrentSince Jun 20, 2024 Accepting new patients

Locations

677 Ala Moana Blvd
Spc 950
Honolulu, HI 96813
Phone (808) 535-5555

Networks

  • devoted network organization-c89d4c14-e90f-4cf7-83f9-456527a52335
  • HI PPO

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1264118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264118400000",
    "number": "1003147547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 AOLOA STREET",
            "address_2": "A210",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "96734",
            "telephone_number": "808-783-9245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1188 BISHOP STREET",
            "address_2": "SUITE 3206",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "96813",
            "telephone_number": "808-783-9245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMARA",
        "first_name": "GINA LYN",
        "middle_name": "CHERYL AYA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-22",
        "last_updated": "2010-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "HI",
            "license": "PSY-1092",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "HI",
            "license": "PSY-1092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.