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General NPI Number Information
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NPI Number | 1659890937
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Entity Type | Individual
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Provider Name | ASAKO CLAIRE MATSUURA PHD
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Gender | Female
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Dates
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Enumeration Date | 09/18/2017
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Last Update Date | 09/23/2022
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Provider Practice Location Address
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Address Line | 2520 MIDWAY RD STE 100
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City | VIRGINIA BEACH
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State | VA
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Zip | 23459-3323
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Country | US
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Telephone | 757-752-4632
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Fax |
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Provider Business Mailing Address
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Address Line | 620 JOHN PAUL JONES CIR BLDG 104
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City | PORTSMOUTH
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State | VA
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Zip | 23708-2111
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Country | US
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Telephone | 757-953-9767
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Fax |
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 0810005831
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY60282161
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0810005831
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License Number State | VA
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