Healthcare Provider Details

I. General information

NPI: 1720995400
Provider Name (Legal Business Name): KARASU JOSHUA TOKIOKA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 E ROUTE 66 STE 203
FLAGSTAFF AZ
86001-5777
US

IV. Provider business mailing address

16 E ROUTE 66 STE 203
FLAGSTAFF AZ
86001-5777
US

V. Phone/Fax

Practice location:
  • Phone: 928-606-2907
  • Fax: 928-248-1511
Mailing address:
  • Phone: 928-606-2907
  • Fax: 928-248-1511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLAC-23029
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: