Active NPI
Jennifer Malia Takahashi, PSY.D.
- Clinical Psychologist
- Honolulu, HI
National Provider Identifier
1073657128
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 730
- Practice address
- 1215 Center St
Suite 203
Honolulu, HI 96816-3209 - Phone
- (808) 271-0200
- NPI assigned
- Feb 19, 2007
- 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 | 730 | HI | Primary |
Addresses
Primary practice location
1215 Center St
Suite 203
Honolulu, HI 96816-3209
Mailing address
3946 Harding Ave
Honolulu, HI 96816-4110
Phone (808) 737-1078
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000236216 | Other | HI | HMSA-QUEST |
| 500258 | Medicaid | HI | |
| 23621-6 | Other | HI | HMSA |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 730 | HI | MD | Forensic Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1345075200000",
"number": "1073657128",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3946 HARDING AVE",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968164110",
"telephone_number": "808-737-1078"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1215 CENTER ST",
"address_2": "SUITE 203",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968163209",
"telephone_number": "808-271-0200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAKAHASHI",
"first_name": "JENNIFER",
"middle_name": "MALIA",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-19",
"last_updated": "2012-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "HI",
"license": "730",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HMSA-QUEST",
"identifier": "0000236216",
"state": "HI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500258",
"state": "HI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HMSA",
"identifier": "23621-6",
"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 Aug 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.