Provider Demographics
NPI:1629596564
Name:FLORSHEIM, MAYA GABRIELLE (PSYD)
Entity type:Individual
Prefix:DR
First Name:MAYA
Middle Name:GABRIELLE
Last Name:FLORSHEIM
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45-995 WAILELE RD APT 17
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-3034
Mailing Address - Country:US
Mailing Address - Phone:510-333-4588
Mailing Address - Fax:
Practice Address - Street 1:1441 KAPIOLANI BLVD STE 1114
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-4406
Practice Address - Country:US
Practice Address - Phone:510-213-8735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-30
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34467103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical