Healthcare Provider Details

I. General information

NPI: 1386581890
Provider Name (Legal Business Name): KAVAN NAKAI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9327 FAIRWAY VIEW PL STE 110
RANCHO CUCAMONGA CA
91730-0969
US

IV. Provider business mailing address

6342 TRIBECA CT
RANCHO CUCAMONGA CA
91739-2277
US

V. Phone/Fax

Practice location:
  • Phone: 909-945-3330
  • Fax:
Mailing address:
  • Phone: 909-243-4154
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberAPCC22564
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: