Individual provider Active NPI

Jennifer M. Yamashita, PH.D.

  • Clinical Neuropsychologist
  • Tripler Army Medical Center, HI
National Provider Identifier
1396917282
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
1000 Issued in HI
Practice address
1 Jarrett White Rd
Tripler Army Medical Center, HI 96859-5001
Phone
(808) 433-3352
NPI assigned
Mar 31, 2008
Last updated
May 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 1000 HI Primary

Addresses

Primary practice location

1 Jarrett White Rd
Tripler Army Medical Center, HI 96859-5001

Mailing address

4211 Waialae Ave Ste 207
Honolulu, HI 96816-5312
Phone (808) 222-3996

Other practice location 1

4211 Waialae Ave
Ste 206B
Honolulu, HI 96816-5312
Phone (808) 222-3996

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
I20200102002814 HI Practitioner - Clinical Psychologist 8426482290 Practice locations: Honolulu, HI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4211 Waialae Ave
Suite 206B
Honolulu, HI 96816-5312
Phone (808) 222-3996

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1000HIMDClinical Neuropsychologist

NPI Registry JSON

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

{
    "created_epoch": "1206921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1396917282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4211 WAIALAE AVE STE 207",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968165312",
            "telephone_number": "808-222-3996",
            "fax_number": "844-640-0677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 JARRETT WHITE RD",
            "city": "TRIPLER ARMY MEDICAL CENTER",
            "state": "HI",
            "postal_code": "968595001",
            "telephone_number": "808-433-3352"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4211 WAIALAE AVE",
            "address_2": "STE 206B",
            "address_purpose": "LOCATION",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968165312",
            "country_code": "US",
            "telephone_number": "808-222-3996",
            "fax_number": "808-200-5629",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YAMASHITA",
        "first_name": "JENNIFER",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-31",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "HI",
            "license": "1000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tripler Army Medical Center, HI

Sources for this page

Verify at the official NPI Registry.