Provider Demographics
NPI:1366596173
Name:CUMMINGS, THOMAS ALAN (PHD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ALAN
Last Name:CUMMINGS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:589 IANA ST
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-3408
Mailing Address - Country:US
Mailing Address - Phone:808-292-0962
Mailing Address - Fax:808-738-5821
Practice Address - Street 1:328 ULUNIU ST
Practice Address - Street 2:SUITE 207
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2547
Practice Address - Country:US
Practice Address - Phone:808-292-0962
Practice Address - Fax:808-738-5821
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY 781103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI557952-00OtherALOHA CARE PP
HI0000238907OtherHMSA HAWAII KAI OFFICE
HI5579-5200Medicaid
HI0000238907OtherHMSA HAWAII KAI OFFICE