Individual provider Active NPI

Maryruth Eaves-Herrera, PHD

  • Psychologist
  • Hilo, HI
National Provider Identifier
1841591112
Registry record updated Jan 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1185 Issued in HI
Practice address
101 Aupuni St
Ste 313
Hilo, HI 96720-4262
Phone
(719) 659-6035
NPI assigned
Nov 3, 2010
Last updated
Jan 26, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1185 HI Primary

Addresses

Primary practice location

101 Aupuni St
Ste 313
Hilo, HI 96720-4262

Mailing address

101 Aupuni St
Suite 313
Hilo, HI 96720-4246
Phone (808) 238-0543

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1185HIMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1288742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296000000000",
    "number": "1841591112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 AUPUNI ST",
            "address_2": "SUITE 313",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967204246",
            "telephone_number": "808-238-0543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 AUPUNI ST",
            "address_2": "STE 313",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967204262",
            "telephone_number": "719-659-6035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EAVES-HERRERA",
        "first_name": "MARYRUTH",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-03",
        "last_updated": "2011-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "HI",
            "license": "1185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilo, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2011; 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.