Healthcare Provider Details
I. General information
NPI: 1174435820
Provider Name (Legal Business Name): L. KIKI HACHIYA, PHD
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7340 RIDGEWAY RD
GOLDEN VALLEY MN
55427-4855
US
IV. Provider business mailing address
7340 RIDGEWAY RD
GOLDEN VALLEY MN
55427-4855
US
V. Phone/Fax
- Phone: 612-859-4248
- Fax:
- Phone: 612-859-4248
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
LAURA
HACHIYA
Title or Position: PSYCHOLOGIST/OWNER
Credential: PHD
Phone: 612-859-4248