Active NPI
Sousada Phitsamay
- Occupational Therapist
- Kapolei, HI
National Provider Identifier
1922215342
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 694
- Practice address
- 575 Farrington Hwy
Kapolei, HI 96707-2001 - Phone
- (808) 674-9262
- NPI assigned
- May 16, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 694 | HI | Primary |
Addresses
Primary practice location
575 Farrington Hwy
Kapolei, HI 96707-2001
Mailing address
91-1039 Hanapaa St
Kapolei, HI 96707-1937
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 694 | HI | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1922215342",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "91-1039 HANAPAA ST",
"city": "KAPOLEI",
"state": "HI",
"postal_code": "967071937"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "575 FARRINGTON HWY",
"city": "KAPOLEI",
"state": "HI",
"postal_code": "967072001",
"telephone_number": "808-674-9262"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHITSAMAY",
"first_name": "SOUSADA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "HI",
"license": "694",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kapolei, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.