Provider Demographics
NPI:1215982616
Name:CUMES, JEFFREY WINSTON (PHD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:WINSTON
Last Name:CUMES
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:PO BOX 1323
Mailing Address - Street 2:
Mailing Address - City:KEALAKEKUA
Mailing Address - State:HI
Mailing Address - Zip Code:96750-1323
Mailing Address - Country:US
Mailing Address - Phone:808-323-9510
Mailing Address - Fax:808-323-9703
Practice Address - Street 1:81-6587 MAMALAHOA HWY
Practice Address - Street 2:BLDG C #23
Practice Address - City:KEALAKEKUA
Practice Address - State:HI
Practice Address - Zip Code:96750-8133
Practice Address - Country:US
Practice Address - Phone:808-323-9510
Practice Address - Fax:808-323-9703
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY388103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI04952101Medicaid
HI56341OtherHMSA ID
HI04952101Medicaid