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Individual

DR. TIMOTHY KEMP AMBROSE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
14-4034 PAHOA-KALAPANA ROAD, PAHOA, HI 96778
(808) 965-9416
(808) 965-1661
Mailing address
PO BOX 1476, PAHOA, HI 96778-1476
(808) 965-9416
(808) 965-1661

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY-735
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000240218
QUEST PIN NUMBER
HI
01
0240218
HMSA PIN NUMBER
HI
01
53129501
ALOHACARE PIN NUMBER
HI
05
53129501
HI
01
PSY-735
QUEENS MDX PIN NUMBER
HI
Enumeration date
09/20/2006
Last updated
07/09/2007
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