Healthcare Provider Details

I. General information

NPI: 1366852089
Provider Name (Legal Business Name): KUMIKO KAWASAKI LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2014
Last Update Date: 05/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

988 HOWARD ST
SAN FRANCISCO CA
94103-4183
US

IV. Provider business mailing address

988 HOWARD ST
SAN FRANCISCO CA
94103-4183
US

V. Phone/Fax

Practice location:
  • Phone: 415-975-0908
  • Fax: 415-975-9932
Mailing address:
  • Phone: 415-975-0908
  • Fax: 415-975-9932

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number29782
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: