Individual provider Active NPI

Anntonette Gonzales Capre, PSY.D.

  • Clinical Psychologist
  • Pearl Harbor, HI
National Provider Identifier
1700048220
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 23980 Issued in CA
Practice address
Naval Health Clinic Hawaii
480 Central Avenue
Pearl Harbor, HI 96860
Phone
(808) 473-0650
NPI assigned
Jun 26, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY23980 CA
Clinical Psychologist 103TC0700X PSY 23980 CA Primary

Addresses

Primary practice location

Naval Health Clinic Hawaii
480 Central Avenue
Pearl Harbor, HI 96860

Mailing address

Naval Health Clinic Hawaii
480 Central Avenue
Pearl Harbor, HI 96860-4908
Phone (808) 473-0650

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY 23980CAMDClinical Psychologist
PSY23980CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1700048220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NAVAL HEALTH CLINIC HAWAII",
            "address_2": "480 CENTRAL AVENUE",
            "city": "PEARL HARBOR",
            "state": "HI",
            "postal_code": "968604908",
            "telephone_number": "808-473-0650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NAVAL HEALTH CLINIC HAWAII",
            "address_2": "480 CENTRAL AVENUE",
            "city": "PEARL HARBOR",
            "state": "HI",
            "postal_code": "96860",
            "telephone_number": "808-473-0650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPRE",
        "first_name": "ANNTONETTE",
        "middle_name": "GONZALES",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-26",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY23980",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 23980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearl Harbor, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; 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.