Provider Demographics
NPI:1134283393
Name:MIYAGI, KUNIKO (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KUNIKO
Middle Name:
Last Name:MIYAGI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:KUNIKO
Other - Middle Name:MIYAGI
Other - Last Name:PLATT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:4510 E PACIFIC COAST HWY STE 600
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-6914
Mailing Address - Country:US
Mailing Address - Phone:562-346-1100
Mailing Address - Fax:
Practice Address - Street 1:4510 E PACIFIC COAST HWY STE 600
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90804-6914
Practice Address - Country:US
Practice Address - Phone:562-346-1100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS-160151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical