Provider Demographics
NPI:1073185476
Name:SUZUKI, YUKARI
Entity Type:Individual
Prefix:
First Name:YUKARI
Middle Name:
Last Name:SUZUKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1409 W CARROLL AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-1105
Mailing Address - Country:US
Mailing Address - Phone:312-733-0883
Mailing Address - Fax:
Practice Address - Street 1:107 NATALIE DR
Practice Address - Street 2:
Practice Address - City:MORAGA
Practice Address - State:CA
Practice Address - Zip Code:94556-2415
Practice Address - Country:US
Practice Address - Phone:510-695-3593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-14
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician