Active NPI
Lynda H. Jaques, PSYD
- Clinical Psychologist
- Honolulu, HI
National Provider Identifier
1023102647
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY695
- Practice address
- 1833 Kalakaua Ave
Suite 800
Honolulu, HI 96815-1512 - Phone
- (808) 222-4166
- NPI assigned
- Oct 3, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY695 | HI | Primary |
Addresses
Primary practice location
1833 Kalakaua Ave
Suite 800
Honolulu, HI 96815-1512
Mailing address
1487 Hiikala Place #5
Honolulu, HI 96816-5633
Phone (808) 732-7620
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| B228078 | Other | HI | HMSA |
| 1039057 | Other | HI | CIGNA HEALTH CARE |
| 501694 | Medicaid | HI | |
| 520167 | Other | HI | HMA SUMMERLIN |
| PSY695 | Other | HI | QUEENS HEALTH PLANS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY695 | HI | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psychological Services LLC | Clinical | Past | Accepting new patients |
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.
-
- Clinical Psychologist
- Honolulu, HI
- NPI 1659704047
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203292800000",
"number": "1023102647",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1487 HIIKALA PLACE #5",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968165633",
"telephone_number": "808-732-7620"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1833 KALAKAUA AVE",
"address_2": "SUITE 800",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968151512",
"telephone_number": "808-222-4166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAQUES",
"first_name": "LYNDA",
"middle_name": "H.",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-03",
"last_updated": "2008-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "HI",
"license": "PSY695",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HMSA",
"identifier": "B228078",
"state": "HI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA HEALTH CARE",
"identifier": "1039057",
"state": "HI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "501694",
"state": "HI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HMA SUMMERLIN",
"identifier": "520167",
"state": "HI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "QUEENS HEALTH PLANS",
"identifier": "PSY695",
"state": "HI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Honolulu, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.