Walter R. Jaeckle I, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY 116 Issued in HI

Practice address

65-1235 Opelo Rd
Suite 1
Kamuela, HI 96743-8454

Phone

(808) 885-1045

Fax

(808) 885-1045

NPI assigned

May 17, 2006

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1861445413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65-1235 OPELO RD",
            "address_2": "SUITE 1",
            "city": "KAMUELA",
            "state": "HI",
            "postal_code": "967438454",
            "telephone_number": "808-885-1045",
            "fax_number": "808-885-1045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65-1235 OPELO RD",
            "address_2": "SUITE 1",
            "city": "KAMUELA",
            "state": "HI",
            "postal_code": "967438454",
            "telephone_number": "808-885-1045",
            "fax_number": "808-885-1045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAECKLE",
        "first_name": "WALTER",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "HI",
            "license": "PSY 116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00402265",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stinson Edward Humphrey, MD
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• Peter A. In, M.D.
• Liberty Jacques, DNP, RN, ACNS-BC
• John Mascaro PHD
• Nancy N. Johnson, M.A.
• Paul E. Johnston, MD
• Troy Alan Jones, MPT
• Justin Chan DDS

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.