Provider Demographics
NPI:1144320847
Name:RAPOSO, EVELYNE (PSYD)
Entity type:Individual
Prefix:
First Name:EVELYNE
Middle Name:
Last Name:RAPOSO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:569 HAO ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96821-1645
Mailing Address - Country:US
Mailing Address - Phone:808-373-2667
Mailing Address - Fax:
Practice Address - Street 1:569 HAO ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96821-1645
Practice Address - Country:US
Practice Address - Phone:808-373-2667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY 612103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIA22220-6OtherHMSA PROVIDER NUMBER