Individual provider Active NPI

Jaime Puahiehieikamaka Chang, PH.D.

  • Clinical Psychologist
  • Honolulu, HI
National Provider Identifier
1497067110
Registry record updated Nov 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1746 Issued in HI
Practice address
1188 Bishop St Ste 2101
Honolulu, HI 96813-3308
Phone
(808) 285-4776
NPI assigned
Jul 10, 2010
Last updated
Nov 28, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Psychologist 103TC0700X 1746 HI Primary

Addresses

Primary practice location

1188 Bishop St Ste 2101
Honolulu, HI 96813-3308

Mailing address

2530 Dole St
Krauss Hall 101M
Honolulu, HI 96822

Other practice location 1

1601 East-West Rd
Room 4021
Honolulu, HI 96848
Phone (808) 956-9559

Other practice location 2

2530 Dole St
Krauss Hall 101M
Honolulu, HI 96822
Phone (808) 956-6496

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1746HIMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Jaime Pua Chang LLC Current Accepting new patients
Heather McDermott PSYD PLLC PastSince Apr 3, 2022 Accepting new patients

Organizations & group practices 2

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": "1278720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543363200000",
    "number": "1497067110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 DOLE ST",
            "address_2": "KRAUSS HALL 101M",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "96822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1188 BISHOP ST STE 2101",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968133308",
            "telephone_number": "808-285-4776"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1601 East-West Rd",
            "address_2": "Room 4021",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "96848",
            "country_code": "US",
            "telephone_number": "808-956-9559",
            "fax_number": "808-956-2218",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2530 Dole St",
            "address_2": "Krauss Hall 101M",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "96822",
            "country_code": "US",
            "telephone_number": "808-956-6496",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANG",
        "first_name": "JAIME",
        "middle_name": "PUAHIEHIEIKAMAKA",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-10",
        "last_updated": "2018-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "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": "1746",
            "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 Nov 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.