Provider Demographics
NPI:1649463266
Name:CHUN, KATHRYN MALIA (PHD)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:MALIA
Last Name:CHUN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 W HIND DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96821-1855
Mailing Address - Country:US
Mailing Address - Phone:808-256-9490
Mailing Address - Fax:808-748-0537
Practice Address - Street 1:3140 WAIALAE AVE
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-1510
Practice Address - Country:US
Practice Address - Phone:808-256-9490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-27
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY985103TC0700X
HIPSY 985103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000268706OtherHAWAII MEDICAL SERVICE ASSOCIATION