Individual provider Active NPI

Michael Keokolo Quong, PSY.D.

  • Clinical Psychologist
  • Honolulu, HI
National Provider Identifier
1619141744
Registry record updated Apr 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY-1039 Issued in HI
Practice address
615 Piikoi St Ste 105
Honolulu, HI 96814-3139
Phone
(808) 596-8433
Fax
(808) 591-1017
NPI assigned
Apr 18, 2008
Last updated
Apr 18, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY-1039 HI Primary

Addresses

Primary practice location

615 Piikoi St Ste 105
Honolulu, HI 96814-3139

Mailing address

615 Piikoi St Ste 105
Honolulu, HI 96814-3139
Phone (808) 596-8433

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

LicenseStateTypeSpecialty
PSY-1039HIMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1208476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208476800000",
    "number": "1619141744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 PIIKOI ST STE 105",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968143139",
            "telephone_number": "808-596-8433",
            "fax_number": "808-591-1017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 PIIKOI ST STE 105",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968143139",
            "telephone_number": "808-596-8433",
            "fax_number": "808-591-1017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUONG",
        "first_name": "MICHAEL",
        "middle_name": "KEOKOLO",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-18",
        "last_updated": "2008-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "HI",
            "license": "PSY-1039",
            "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 Apr 18, 2008; 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.