Individual provider Active NPI

Haunani M. Iao, PSY.D

  • Clinical Psychologist
  • Kula, HI
National Provider Identifier
1659560753
Registry record updated May 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 1210 Issued in HI
Practice address
664 Lauie Dr
Kula, HI 96790-7218
Phone
(808) 389-2611
NPI assigned
Oct 15, 2007
Last updated
May 4, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2020

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 1210 HI Primary

Addresses

Primary practice location

664 Lauie Dr
Kula, HI 96790-7218

Mailing address

PO Box 722
Kula, HI 96790-0722
Phone (808) 389-2611

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110202000162 HI Practitioner - Clinical Psychologist 9638359052 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY 1210HIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Iao Mind & Body Health, LLC Clinical CurrentSince May 8, 2020 Accepting new patients

Locations

2180 Main St
Wailuku, HI 96793
Phone (808) 242-4267

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, 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": "1192406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588550400000",
    "number": "1659560753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 722",
            "city": "KULA",
            "state": "HI",
            "postal_code": "967900722",
            "telephone_number": "808-389-2611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "664 LAUIE DR",
            "city": "KULA",
            "state": "HI",
            "postal_code": "967907218",
            "telephone_number": "808-389-2611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IAO",
        "first_name": "HAUNANI",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-15",
        "last_updated": "2020-05-04",
        "certification_date": "2020-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "HI",
            "license": "PSY 1210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kula, HI

Sources for this page

Verify at the official NPI Registry.