Active NPI
Marielis Jepson, PSY.D.
- Clinical Psychologist
- Kihei, HI
National Provider Identifier
1396792966
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 608
- Practice address
- 1280 S Kihei Rd
Suite 302 Azeka Makai Shopping Center
Kihei, HI 96753-8240 - Phone
- (808) 875-8737
- NPI assigned
- May 28, 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 | 608 | HI | Primary |
Addresses
Primary practice location
1280 S Kihei Rd
Suite 302 Azeka Makai Shopping Center
Kihei, HI 96753-8240
Mailing address
PO Box 724
Kihei, HI 96753-0724
Phone (808) 875-8737
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 539611 | Medicaid | HI |
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 |
|---|---|---|---|
| 608 | HI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191456000000",
"number": "1396792966",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 724",
"city": "KIHEI",
"state": "HI",
"postal_code": "967530724",
"telephone_number": "808-875-8737"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1280 S KIHEI RD",
"address_2": "SUITE 302 AZEKA MAKAI SHOPPING CENTER",
"city": "KIHEI",
"state": "HI",
"postal_code": "967538240",
"telephone_number": "808-875-8737"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEPSON",
"first_name": "MARIELIS",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-28",
"last_updated": "2007-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "HI",
"license": "608",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "539611",
"state": "HI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kihei, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.