Active NPI
Kimberly Mizo, PSY.D.
- Clinical Psychologist
- Honolulu, HI
National Provider Identifier
1609216266
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY1531
- Practice address
- 3627 Kilauea Ave
Honolulu, HI 96816-2317 - Phone
- (808) 733-9393
- NPI assigned
- Jun 27, 2013
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY1531 | HI | Primary |
Addresses
Primary practice location
3627 Kilauea Ave
Honolulu, HI 96816-2317
Mailing address
3627 Kilauea Ave # 401
Honolulu, HI 96816-2317
Phone (808) 733-9393
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY1531 | HI | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of Hawaii Department of Health | Current | Accepting new patients |
Interoperability endpoints
- kimberly.mizo@hawaiihie.medicity.net
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Honolulu, HI
- NPI 1689832511
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1372291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1453680000000",
"number": "1609216266",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3627 KILAUEA AVE # 401",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968162317",
"telephone_number": "808-733-9393"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3627 KILAUEA AVE",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968162317",
"telephone_number": "808-733-9393"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIZO",
"first_name": "KIMBERLY",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-27",
"last_updated": "2016-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "HI",
"license": "PSY1531",
"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 Jan 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.