NPIMap

Organization Active NPI

Conrad Bugarin Bernisto

  • Clinical Psychologist
  • Waipahu, HI
National Provider Identifier
1245585058
Registry record updated Jul 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY-1291 Issued in HI
Legal business name
CONRAD BUGARIN BERNISTO
Practice address
94-141 Makoa St
Waipahu, HI 96797-4728
Phone
(808) 282-1907
NPI assigned
Jul 18, 2012
Last updated
Jul 18, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2012

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

Authorized official

Name
Conrad Bernisto, PSYDNPI 1164778445
Title
Owner
Phone
(808) 282-1907

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY-1291 HI Primary

Addresses

Primary practice location

94-141 Makoa St
Waipahu, HI 96797-4728

Mailing address

4348 Waialae Ave # 656
Honolulu, HI 96816-5767
Phone (808) 282-1907

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1342569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342569600000",
    "number": "1245585058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4348 WAIALAE AVE # 656",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968165767",
            "telephone_number": "808-282-1907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94-141 MAKOA ST",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967974728",
            "telephone_number": "808-282-1907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONRAD BUGARIN BERNISTO",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-18",
        "last_updated": "2012-07-18",
        "status": "A",
        "authorized_official_last_name": "BERNISTO",
        "authorized_official_first_name": "CONRAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-282-1907",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "HI",
            "license": "PSY-1291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waipahu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.

Verify at the official NPI Registry.