Provider Demographics
NPI:1225174923
Name:HARUNAGA, KIM TOSHIO (BA MHRS)
Entity Type:Individual
Prefix:MR
First Name:KIM
Middle Name:TOSHIO
Last Name:HARUNAGA
Suffix:
Gender:M
Credentials:BA MHRS
Other - Prefix:MR
Other - First Name:KIMBO
Other - Middle Name:TOSHIO
Other - Last Name:HARUNAGA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BA MHRS
Mailing Address - Street 1:2001 THE ALAMEDA
Mailing Address - Street 2:ALLIANCE FOR COMMUNITY CARE
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-1136
Mailing Address - Country:US
Mailing Address - Phone:408-261-7777
Mailing Address - Fax:408-254-9960
Practice Address - Street 1:2001 THE ALAMEDA
Practice Address - Street 2:ALLIANCE FOR COMMUNITY CARE SERVICE TEAM ADULT OUTPATIE
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-1136
Practice Address - Country:US
Practice Address - Phone:408-261-7777
Practice Address - Fax:408-254-9960
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator