Individual provider Active NPI

Kevin Mamoru Chom Duk Akiyama, PSY.D

  • Clinical Psychologist
  • Waianae, HI
National Provider Identifier
1487974838
Registry record updated Feb 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2179 Issued in HI
Practice address
86-260 Farrington Hwy
Waianae, HI 96792-3128
Phone
(808) 697-3300
NPI assigned
Jun 8, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
School Counselor 101YS0200X CA
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Psychologist 103TC0700X 2179 HI Primary

Addresses

Primary practice location

86-260 Farrington Hwy
Waianae, HI 96792-3128

Mailing address

86-260 Farrington Hwy
Waianae, HI 96792-3128
Phone (808) 697-3300

Other practice location 1

1918 University Ave Ste 2B
Berkeley, CA 94704-3264
Phone (510) 841-9230

Other practice location 2

45-021 Likeke Pl
Kaneohe, HI 96744-2426
Phone (808) 235-1377 ext. 225

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
I20240826000675 HI Practitioner - Clinical Psychologist 3274072004 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2179HIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Waianae District Comprehensive Health and Hospital Board, Inc CurrentSince Jul 23, 2024 Accepting new patients
Waianae District Comprehensive Health and Hospital Board, Incorporated CurrentSince Jul 23, 2024 Accepting new patients
Waianae District Comprehensive Health and Hospital Board, Inc Current Accepting new patients

Locations

86-260 Farrington Hwy
Waianae, HI 96792
Phone (808) 696-7081

Interoperability endpoints

  • Direct secure messaging: kevin.akiyama.p1@direct.wcchc.nextgenshare.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1275955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740182400000",
    "number": "1487974838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86-260 FARRINGTON HWY",
            "city": "WAIANAE",
            "state": "HI",
            "postal_code": "967923128",
            "telephone_number": "808-697-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86-260 FARRINGTON HWY",
            "city": "WAIANAE",
            "state": "HI",
            "postal_code": "967923128",
            "telephone_number": "808-697-3300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1918 University Ave Ste 2B",
            "address_purpose": "LOCATION",
            "city": "Berkeley",
            "state": "CA",
            "postal_code": "947043264",
            "country_code": "US",
            "telephone_number": "510-841-9230",
            "fax_number": "510-841-0167",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "45-021 Likeke Pl",
            "address_purpose": "LOCATION",
            "city": "Kaneohe",
            "state": "HI",
            "postal_code": "967442426",
            "country_code": "US",
            "telephone_number": "808-235-1377 x225",
            "fax_number": "808-235-1074",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AKIYAMA",
        "first_name": "KEVIN",
        "middle_name": "MAMORU CHOM DUK",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-08",
        "last_updated": "2025-02-22",
        "certification_date": "2025-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "HI",
            "license": "2179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waianae, HI

Sources for this page

Verify at the official NPI Registry.