Timothy Kemp Ambrose, PH.D.
Individual provider Active NPI Clinical Psychologist · Pahoa, HI
NPI 1003913435 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1003913435
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PSY-735 (HI)
- Practice address
- 14-4034 Pahoa-Kalapana Road
Pahoa, HI 96778 - Phone
- (808) 965-9416
- Fax
- (808) 965-1661
- NPI assigned
- Sep 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY-735 | HI | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY-735 | HI | Yes |
Addresses
Primary practice location
14-4034 Pahoa-Kalapana Road
Pahoa, HI 96778
Mailing address
PO Box 1476
Pahoa, HI 96778-1476
Phone (808) 965-9416
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 53129501 | Other | HI | ALOHACARE PIN NUMBER |
| 53129501 | Medicaid | HI | |
| PSY-735 | Other | HI | QUEENS MDX PIN NUMBER |
| 0000240218 | Other | HI | QUEST PIN NUMBER |
| 0240218 | Other | HI | HMSA PIN NUMBER |
Other providers in Pahoa, HI
- Ac Behavior Consulting LLC
- Stephanie Accalia
- Annalisa Alberto
- All-Phases Consultations LLC
- Aloha Aina Wellness Center
- Giliana Andrade
- Tiaremarie Kuuipo Anguay
- Apple a Day Primary Care LLC
- Maria A Arroyo
- Atlantis Locum Group, LLC
All providers in Pahoa, HI · Clinical Psychologist in Hawaii
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.