Active NPI
Theresia Waltraud Presbrey, PHD
- Psychologist
- Hilo, HI
National Provider Identifier
1518054972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY317
- Practice address
- 101 Aupuni St
Suite 240
Hilo, HI 96720-4262 - Phone
- (808) 935-3395
- Fax
- (808) 969-6843
- NPI assigned
- Oct 6, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY317 | HI | Primary |
Addresses
Primary practice location
101 Aupuni St
Suite 240
Hilo, HI 96720-4262
Mailing address
101 Aupuni St
Suite 240
Hilo, HI 96720-4262
Phone (808) 935-3395
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04225001 | 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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY317 | HI | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1518054972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 AUPUNI ST",
"address_2": "SUITE 240",
"city": "HILO",
"state": "HI",
"postal_code": "967204262",
"telephone_number": "808-935-3395",
"fax_number": "808-969-6843"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 AUPUNI ST",
"address_2": "SUITE 240",
"city": "HILO",
"state": "HI",
"postal_code": "967204262",
"telephone_number": "808-935-3395",
"fax_number": "808-969-6843"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRESBREY",
"first_name": "THERESIA",
"middle_name": "WALTRAUD",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "HI",
"license": "PSY317",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "04225001",
"state": "HI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hilo, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.