Provider Demographics
NPI:1033659875
Name:TAKAHASHI, EMI (MS, ATC, CSCS, CES)
Entity Type:Individual
Prefix:MS
First Name:EMI
Middle Name:
Last Name:TAKAHASHI
Suffix:
Gender:F
Credentials:MS, ATC, CSCS, CES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1306 EAST LOFTUS LANE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710
Mailing Address - Country:US
Mailing Address - Phone:806-392-4755
Mailing Address - Fax:
Practice Address - Street 1:1630 E BULLDOG LANE OF 87
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93740-7400
Practice Address - Country:US
Practice Address - Phone:559-278-4170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-27
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20000252022255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer