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NPI Code Detail

MEDICARE: MR. KYLE NAGANUMA

MEDICARE: MR. KYLE NAGANUMA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial WorkerCA

General Provider Information

NPI Number : 1508266487
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. KYLE NAGANUMA
Provider Business Mailing Address
First Line : 3800 COOLIDGE AVE
Second Line :
City : OAKLAND
State : CA
Zip : 94602-3399
Country : US
Telephone Number : 510-418-7197
Fax Number :
Provider Business Practice Location Address
First Line : 3800 COOLIDGE AVE
Second Line :
City : OAKLAND
State : CA
Zip : 94602-3399
Country : US
Telephone Number : 510-418-7197
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2014
Last Update Date : 12/05/2025

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Directions to “ MR. KYLE NAGANUMA ” Practice Location

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