Michael Richard Bressem, PH D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY369 Issued in HI

Practice address

98-1247 Kaahumanu St
Suite 223
Aiea, HI 96701-5310

Phone

(808) 487-5433

Fax

(808) 487-5444

NPI assigned

Jul 28, 2006

Last updated

Jul 8, 2007By 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 3

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": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982618377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98-1247 KAAHUMANU ST",
            "address_2": "SUITE 223",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967015310",
            "telephone_number": "808-487-5433",
            "fax_number": "808-487-5444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98-1247 KAAHUMANU ST",
            "address_2": "SUITE 223",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967015310",
            "telephone_number": "808-487-5433",
            "fax_number": "808-487-5444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRESSEM",
        "first_name": "MICHAEL",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "PH D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "HI",
            "license": "PSY369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS TRICARE",
            "identifier": "A006",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "24406",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02205402",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Elise Shumaker Bradley
• Brandon D. Young, MD, LLC
• Brandon J McNichols PSYD, LLC
• Zachary Branning, DC
• Havalyn Bremer
• Ciera Brocato
• Taylor Brock
• Mirella Vasquez Brooks, NP
• Connie Louise Brougham
• Bria Shauntea Brown

• Clinical Psychologist in Aiea, HI
• Providers in Aiea, HI by specialty
• Clinical Psychologist in Hawaii

• 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.

Verify at the official NPI Registry.