Healthcare Provider Details

I. General information

NPI: 1750178810
Provider Name (Legal Business Name): NATSUNE KUBO MSW, PPS-C, ASW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2025
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 JANES RD
ARCATA CA
95521-4797
US

IV. Provider business mailing address

3001 JANES RD
ARCATA CA
95521-4797
US

V. Phone/Fax

Practice location:
  • Phone: 707-822-4619
  • Fax:
Mailing address:
  • Phone: 707-822-4619
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: