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NPI Code Detail

MEDICARE: RAY YOSHIDA M.A

MEDICARE: RAY YOSHIDA M.A
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family TherapistIMF 44300CA

General Provider Information

NPI Number : 1417079310
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAY YOSHIDA M.A
Provider Business Mailing Address
First Line : 1907 W 148TH ST
Second Line :
City : GARDENA
State : CA
Zip : 90249-3358
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 12099 W WASHINGTON BLVD STE 200
Second Line :
City : LOS ANGELES
State : CA
Zip : 90066-2622
Country : US
Telephone Number : 310-751-1182
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2007
Last Update Date : 07/08/2007

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Directions to “ RAY YOSHIDA M.A” Practice Location

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