Healthcare Provider Details

I. General information

NPI: 1902937915
Provider Name (Legal Business Name): ASAKO KUDO-MARKERT M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 SIERRA CT STE C8
PALMDALE CA
93550-7609
US

IV. Provider business mailing address

2547 W OLDFIELD ST
LANCASTER CA
93536-6447
US

V. Phone/Fax

Practice location:
  • Phone: 661-266-4783
  • Fax:
Mailing address:
  • Phone: 661-949-1931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number43543
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: