MEDICARE: MS. MICHIYO OKANO LCSW

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
1	1041C0700X	Clinical Social Worker	6574	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992846083
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MICHIYO OKANO LCSW

Provider Business Mailing Address
First Line	:	8616 LA TIJERA BLVD
Second Line	:	#200
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-3944
Country	:	US
Telephone Number	:	310-337-1550
Fax Number	:	310-337-2805

Provider Business Practice Location Address
First Line	:	8616 LA TIJERA BLVD
Second Line	:	#200
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-3944
Country	:	US
Telephone Number	:	310-337-1550
Fax Number	:	310-337-2805

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2007
Last Update Date	:	07/09/2007

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