Organization Active NPI

Nicole Nakamura, Psy.D., LLC

  • Adult Mental Health Clinic/Center
  • Honolulu, HI
National Provider Identifier
1487089959
Registry record updated Sep 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
1142 Issued in HI
Legal business name
NICOLE NAKAMURA, PSY.D., LLC
Practice address
1833 Kalakaua Ave Ste 908
Honolulu, HI 96815-1528
Phone
(808) 277-8797
NPI assigned
Sep 3, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2013

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

Authorized official

Name
Dr. Nicole Nakamura, PSY.D.NPI 1235382219
Title
Owner
Phone
(808) 277-8797

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
Adult Mental Health Clinic/Center 261QM0850X 1142 HI Primary

Addresses

Primary practice location

1833 Kalakaua Ave Ste 908
Honolulu, HI 96815-1528

Mailing address

3511 Maunaloa Ave
Honolulu, HI 96816-2254
Phone (808) 277-8797

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140217001235 HI Part B Supplier - Clinic/Group Practice 7618105172 Receives reassigned benefits from 1 practitioner
Practice locations: Honolulu, HI

National Provider Directory

National Provider Directory

Locations

3660 Waialae Ave
Ste 208
Honolulu, HI 96816
Phone (808) 256-6518

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1378166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378166400000",
    "number": "1487089959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3511 MAUNALOA AVE",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968162254",
            "telephone_number": "808-277-8797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1833 KALAKAUA AVE STE 908",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968151528",
            "telephone_number": "808-277-8797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICOLE NAKAMURA, PSY.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-03",
        "last_updated": "2013-09-03",
        "status": "A",
        "authorized_official_last_name": "NAKAMURA",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-277-8797",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "HI",
            "license": "1142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.