Healthcare Provider Details

I. General information

NPI: 1063363968
Provider Name (Legal Business Name): RINA ASAKO KAWAMURA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2026
Last Update Date: 02/05/2026
Certification Date: 02/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2613 CAMINO RAMON
SAN RAMON CA
94583-4202
US

IV. Provider business mailing address

8536 PEACHTREE AVE
NEWARK CA
94560-3341
US

V. Phone/Fax

Practice location:
  • Phone: 800-445-5747
  • Fax:
Mailing address:
  • Phone: 510-509-0611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberINT51684
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: