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NPI Code Detail

MEDICARE: YOKO ICHIMURA LCPC

MEDICARE: YOKO ICHIMURA LCPC
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
1101YP2500XProfessional Counselor8495CA

General Provider Information

NPI Number : 1548563315
Entity Type Code : Individual
Provider Name (Legal Business Name) : YOKO ICHIMURA LCPC
Provider Business Mailing Address
First Line : 11845 W OLYMPIC BLVD STE 1050W
Second Line :
City : LOS ANGELES
State : CA
Zip : 90064-5046
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11845 W OLYMPIC BLVD STE 1050W
Second Line :
City : LOS ANGELES
State : CA
Zip : 90064-5046
Country : US
Telephone Number : 707-408-2519
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2010
Last Update Date : 12/02/2024

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Directions to “ YOKO ICHIMURA LCPC” Practice Location

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