Provider Demographics
NPI:1548360167
Name:LOOS, WARREN ROSS (PHD)
Entity type:Individual
Prefix:DR
First Name:WARREN
Middle Name:ROSS
Last Name:LOOS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4348 WAIALAE AVE # 403
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-5767
Mailing Address - Country:US
Mailing Address - Phone:808-284-2200
Mailing Address - Fax:888-668-8527
Practice Address - Street 1:4300 WAIALAE AVE APT B1002
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-5757
Practice Address - Country:US
Practice Address - Phone:808-284-2200
Practice Address - Fax:888-668-8527
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-24
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY-792103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI232967OtherHMSA
HI54463601Medicaid
HI203822633OtherTRICARE
HIH55993Medicare PIN