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General NPI Number Information
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NPI Number | 1700351988
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Entity Type | Individual
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Provider Name | KIMI YOKOMIZO M.ED., BCBA
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Gender | Female
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Dates
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Enumeration Date | 10/03/2018
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Last Update Date | 11/17/2022
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Provider Practice Location Address
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Address Line | 1025 ATLANTIC AVE STE 101
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City | ALAMEDA
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State | CA
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Zip | 94501-1188
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Country | US
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Telephone | 510-268-8120
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Fax |
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Provider Business Mailing Address
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Address Line | 12562 DALE ST UNIT 14
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City | GARDEN GROVE
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State | CA
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Zip | 92841-4564
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Country | US
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Telephone | 818-322-7314
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-18-32280
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License Number State | CA
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