Liza M. Wacker, Psy.D., Inc.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY788 Issued in HI

Legal business name

LIZA M. WACKER, PSY.D., INC.

Practice address

3599 Waialae Avenue
Honolulu, HI 96816

Phone

(808) 927-2587

Fax

(866) 530-6345

NPI assigned

Oct 16, 2013

Organization subpart

No

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

Authorized official

Name

Liza Malia Wacker, PSY.D.NPI 1770641789

Title

President

Phone

(808) 927-2587

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in HI

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Liza Malia Wacker, PSY.D.

  • Clinical Psychologist
  • Honolulu, HI
  • NPI 1770641789
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1381881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381881600000",
    "number": "1720416464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 25809",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "96825",
            "telephone_number": "808-927-2587",
            "fax_number": "866-530-6345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3599 WAIALAE AVENUE",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "96816",
            "telephone_number": "808-927-2587",
            "fax_number": "866-530-6345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIZA M. WACKER, PSY.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-16",
        "last_updated": "2013-10-16",
        "status": "A",
        "authorized_official_last_name": "WACKER",
        "authorized_official_first_name": "LIZA",
        "authorized_official_middle_name": "MALIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "808-927-2587",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "HI",
            "license": "PSY788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Psychologist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.