Individual provider Active NPI

Cindy K. Ikeda, PSY.D.

  • Clinical Psychologist
  • Ewa Beach, HI
National Provider Identifier
1164784575
Registry record updated Mar 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 1176 Issued in HI
Practice address
91-1841 Fort Weaver Rd
Ewa Beach, HI 96706-1909
Phone
(808) 748-3146
NPI assigned
Jun 12, 2012
Last updated
Mar 5, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY 1176 HI Primary

Addresses

Primary practice location

91-1841 Fort Weaver Rd
Ewa Beach, HI 96706-1909

Mailing address

91-1841 Fort Weaver Rd
Ewa Beach, HI 96706-1909
Phone (808) 748-3146

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

LicenseStateTypeSpecialty
PSY 1176HIMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1339459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614902400000",
    "number": "1164784575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91-1841 FORT WEAVER RD",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967061909",
            "telephone_number": "808-748-3146",
            "fax_number": "808-748-3126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91-1841 FORT WEAVER RD",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967061909",
            "telephone_number": "808-748-3146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IKEDA",
        "first_name": "CINDY",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-12",
        "last_updated": "2021-03-05",
        "certification_date": "2021-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "HI",
            "license": "PSY 1176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ewa Beach, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.