Active NPI
Kristina L Lum, PSY.D
- Clinical Psychologist
- Honolulu, HI
National Provider Identifier
1609024884
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1065
- Practice address
- 1188 Bishop St
Ste 1810
Honolulu, HI 96813-3301 - Phone
- (808) 383-3277
- NPI assigned
- Aug 30, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1065 | HI | Primary |
Addresses
Primary practice location
1188 Bishop St
Ste 1810
Honolulu, HI 96813-3301
Mailing address
919 19TH Ave
Honolulu, HI 96816-4604
Phone (808) 383-3211
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20091106000206 | HI | Practitioner - Clinical Psychologist | 3072651389 | Practice locations: Kaneohe, HI |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1065 | HI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1220054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1220054400000",
"number": "1609024884",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "919 19TH AVE",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968164604",
"telephone_number": "808-383-3211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1188 BISHOP ST",
"address_2": "STE 1810",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968133301",
"telephone_number": "808-383-3277"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUM",
"first_name": "KRISTINA",
"middle_name": "L",
"credential": "PSY.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-08-30",
"last_updated": "2008-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "HI",
"license": "1065",
"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 Aug 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.