Basic Information
| Provider Information | |||||||||
| NPI: | 1639323918 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TRAMMEL | ||||||||
| FirstName: | RICKY | ||||||||
| MiddleName: | LOUIS | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PH.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | TRAMMEL | ||||||||
| OtherFirstName: | RICK | ||||||||
| OtherMiddleName: | LOUIS | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | PH.D. | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 6600 KALANIANAOLE HWY STE 225 | ||||||||
| Address2: | |||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968251281 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8083942800 | ||||||||
| FaxNumber: | 8083942826 | ||||||||
| Practice Location | |||||||||
| Address1: | 6600 KALANIANAOLE HWY STE 225 | ||||||||
| Address2: | |||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968251281 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8083942800 | ||||||||
| FaxNumber: | 8083942826 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/12/2008 | ||||||||
| LastUpdateDate: | 11/12/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | PSY 1079 | HI | Y | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.