Healthcare Provider Details

I. General information

NPI: 1154747285
Provider Name (Legal Business Name): MS. KAZUKO YAMAZAKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. KAZUKO HUNSCKE

II. Dates (important events)

Enumeration Date: 03/13/2014
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4510 E PACIFIC COAST HWY
LONG BEACH CA
90804-3279
US

IV. Provider business mailing address

4510 E PACIFIC COAST HWY
LONG BEACH CA
90804-3279
US

V. Phone/Fax

Practice location:
  • Phone: 562-346-1100
  • Fax:
Mailing address:
  • Phone: 562-346-1100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: