Individual provider Active NPI

Maya Gabrielle Florsheim, PSYD

  • Clinical Psychologist
  • Honolulu, HI
National Provider Identifier
1629596564
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
34467 Issued in CA
Practice address
1441 Kapiolani Blvd Ste 1114
Honolulu, HI 96814-4406
Phone
(510) 213-8735
NPI assigned
Aug 30, 2017
Last updated
Jun 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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 34467 CA Primary

Addresses

Primary practice location

1441 Kapiolani Blvd Ste 1114
Honolulu, HI 96814-4406

Mailing address

45-995 Wailele Rd Apt 17
Kaneohe, HI 96744-3034
Phone (510) 333-4588

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, HI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20231018004084 CA Practitioner - Clinical Psychologist 9436504917 Reassigns benefits to 1 organization
I20240718003143 HI Practitioner - Clinical Psychologist 9436504917 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1319 Punahou St
Honolulu, HI 96826-1001
Phone (808) 983-6000

55 Merchant St
Honolulu, HI 96813-4333
Phone (808) 535-7721

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34467CAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Spencer Scott Psychologist Corp Clinical CurrentSince Oct 19, 2023 Accepting new patients
Kapiolani Medical Center for Women & Children CurrentSince Jun 24, 2024 Accepting new patients
Kapiolani Medical Center for Women & Children CurrentSince Jun 24, 2024 Accepting new patients

Locations

4605 Lankershim Blvd
Ste 545
North Hollywood, CA 91602
Phone (323) 999-1395

7720 Painter Ave
Ste C
Whittier, CA 90602
Phone (323) 999-1395

1319 Punahou St
Honolulu, HI 96826
Phone (808) 485-4300

55 Merchant St
Fl 22
Honolulu, HI 96813
Phone (808) 535-7600

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1504051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1629596564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45-995 WAILELE RD APT 17",
            "city": "KANEOHE",
            "state": "HI",
            "postal_code": "967443034",
            "telephone_number": "510-333-4588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 KAPIOLANI BLVD STE 1114",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968144406",
            "telephone_number": "510-213-8735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLORSHEIM",
        "first_name": "MAYA",
        "middle_name": "GABRIELLE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-30",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "34467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.