NPIMap

Organization Active NPI

Metamorphosis, LLC

  • Community/Behavioral Health Agency
  • Kula, HI
National Provider Identifier
1548520091
Registry record updated Mar 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
PSY - 959 Issued in HI
Legal business name
METAMORPHOSIS, LLC
Practice address
50 Calasa Rd
Kula, HI 96790-8101
Phone
(808) 783-4404
NPI assigned
May 17, 2012
Last updated
Mar 7, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2014

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

Authorized official

Name
Dr. Ilana Alaneo Fernandez, PSY.D.NPI 1538283551
Title
Owner
Phone
(808) 783-4404

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
Community/Behavioral Health Agency 251S00000X PSY - 959 HI Primary

Addresses

Primary practice location

50 Calasa Rd
Kula, HI 96790-8101

Mailing address

PO Box 784
Kula, HI 96790-0784
Phone (808) 783-4404

National Provider Directory

National Provider Directory

Locations

50 Calasa Rd
Kula, HI 96790
Phone (808) 783-4404

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1337212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394150400000",
    "number": "1548520091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 784",
            "city": "KULA",
            "state": "HI",
            "postal_code": "967900784",
            "telephone_number": "808-783-4404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 CALASA RD",
            "city": "KULA",
            "state": "HI",
            "postal_code": "967908101",
            "telephone_number": "808-783-4404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METAMORPHOSIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-17",
        "last_updated": "2014-03-07",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ",
        "authorized_official_first_name": "ILANA",
        "authorized_official_middle_name": "ALANEO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-783-4404",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "HI",
            "license": "PSY - 959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kula, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2014; 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.