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General NPI Number Information
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NPI Number | 1477905032
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Entity Type | Individual
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Provider Name | LARA NAKAGAWA CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 07/07/2016
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 725 KAPIOLANI BLVD STE C206
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City | HONOLULU
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State | HI
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Zip | 96813-6024
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Country | US
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Telephone | 808-596-0099
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Fax | 808-596-0099
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Provider Business Mailing Address
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Address Line | 400 29TH ST SUITE 204
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City | OAKLAND
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State | CA
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Zip | 94609-3522
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Country | US
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Telephone | 510-679-3545
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Fax | 510-291-2243
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 23477
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License Number State | CA
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