# PARENT CHILD THERAPY CENTER

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629640859
- **Authorized official:** DR. SHANTEL FERNANDEZ LOPEZ PHD (PSYCHOLOGIST)
- **Authorized official phone:** (808) 681-2309

## Contact information

- **Practice address:** 590 FARRINGTON HWY \# 524-114, KAPOLEI, HI 96707-2009
- **Practice address phone:** (808) 681-2309
- **Mailing address:** 590 FARRINGTON HWY \# 524-114, KAPOLEI, HI 96707-2009
- **Mailing address phone:** (808) 681-2309

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103T00000X | Psychologist | — | NULL | — |
| 103T00000X | Psychologist | — | — | — |
| 103TB0200X | Cognitive & Behavioral Psychologist | — | NULL | — |
| 103TB0200X | Cognitive & Behavioral Psychologist | — | — | — |
| 103TC0700X | Clinical Psychologist | — | NULL | — |
| 103TC0700X | Clinical Psychologist | — | — | — |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | NULL | Yes |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | — | Yes |
| 103TF0000X | Family Psychologist | — | NULL | — |
| 103TF0000X | Family Psychologist | — | — | — |
| 103TP2701X | Group Psychotherapy Psychologist | — | NULL | — |
| 103TP2701X | Group Psychotherapy Psychologist | — | — | — |

## Other

- **Enumeration date:** 07/16/2021
- **Last updated:** 07/16/2021