Individual provider Active NPI

David Jason Wittenberg, PSY.D.

  • Clinical Psychologist
  • Wailuku, HI
National Provider Identifier
1295800639
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY-597 Issued in HI
Practice address
1787 Wili PA Loop Ste 7
Wailuku, HI 96793-1271
Phone
(808) 249-2121
Fax
(808) 242-8920
NPI assigned
Nov 21, 2006
Last updated
Nov 18, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2025

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-597 HI Primary

Addresses

Primary practice location

1787 Wili PA Loop Ste 7
Wailuku, HI 96793-1271

Mailing address

270 Liliuokalani St
Makawao, HI 96768-8630

Other practice location 1

270 Hookahi St Ste 212
Wailuku, HI 96793-1466
Phone (808) 303-1361

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050603000887 HI Practitioner - Clinical Psychologist 4082657739 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aloha House, Inc.Group PAC ID 8426948316, 15 clinicians

Practice addresses (Care Compare)

135 S Wakea Ave
Suite 201
Kahului, HI 96732-1385
Phone (808) 249-2121

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY-597HIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Counseling Group, LLC CurrentSince Feb 24, 2025 Accepting new patients
Aloha House, Inc. CurrentSince Aug 7, 2014 Accepting new patients

Locations

135 S Wakea Ave
Ste 201
Kahului, HI 96732
Phone (808) 242-1660

1787 Wili Pa Loop
Ste 7
Wailuku, HI 96793
Phone (808) 249-2121

270 Hookahi St
Ste 212
Wailuku, HI 96793
Phone (808) 249-2213

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763424000000",
    "number": "1295800639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 LILIUOKALANI ST",
            "city": "MAKAWAO",
            "state": "HI",
            "postal_code": "967688630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1787 WILI PA LOOP STE 7",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967931271",
            "telephone_number": "808-249-2121",
            "fax_number": "808-242-8920"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "270 Hookahi St Ste 212",
            "address_purpose": "LOCATION",
            "city": "Wailuku",
            "state": "HI",
            "postal_code": "967931466",
            "country_code": "US",
            "telephone_number": "808-303-1361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WITTENBERG",
        "first_name": "DAVID",
        "middle_name": "JASON",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "HI",
            "license": "PSY-597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wailuku, HI

Sources for this page

Verify at the official NPI Registry.