Healthcare Provider Details

I. General information

NPI: 1427214469
Provider Name (Legal Business Name): YOSHIKO OKAZAKI LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2008
Last Update Date: 07/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 LONGWOOD AVE FEGAN 5
BOSTON MA
02115-5724
US

IV. Provider business mailing address

300 LONGWOOD AVE, FEGAN 5 CHILDREN'S HOSPITAL BOSTON
BOSTON MA
02115-5737
US

V. Phone/Fax

Practice location:
  • Phone: 617-355-1939
  • Fax: 617-730-0881
Mailing address:
  • Phone: 617-355-1939
  • Fax: 617-730-0881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW 10276491
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: