Provider Demographics
NPI:1235430232
Name:TSUKIOKA, YUKA (NMD)
Entity Type:Individual
Prefix:DR
First Name:YUKA
Middle Name:
Last Name:TSUKIOKA
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:MRS
Other - First Name:YUKA
Other - Middle Name:TSUKIOKA
Other - Last Name:EDGMON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 6194
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92607-6194
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1831 ORANGE AVE
Practice Address - Street 2:SUITE E
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-2839
Practice Address - Country:US
Practice Address - Phone:949-646-4325
Practice Address - Fax:949-646-4313
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-06
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND-228, NDF-228175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath