Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mavis A Mizumoto, PHD

Individual provider Clinical Psychologist · NPI 1396895900

Mavis A Mizumoto, PHD is a Clinical Psychologist in Honolulu, Hawaii. Qualified in 1985, 41 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Hawaii.

Years since qualifying
41
Licensed in
HI
In the registry since
2007
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

1268 Young St Ste 200
Honolulu, HI 96814-1801
Phone: (808) 735-2378
Fax: (808) 597-8183
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence PSY-481 (HI)

Record details

NPI number1396895900
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHD
Sole proprietorYes
NPI enumeratedJanuary 12, 2007
Last updated in NPPESJanuary 30, 2017

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 1985 (41 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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