Provider Demographics
NPI:1326392697
Name:TAKAKI, NANAO (NMD)
Entity Type:Individual
Prefix:DR
First Name:NANAO
Middle Name:
Last Name:TAKAKI
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9887 W BELL RD
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85351-1344
Mailing Address - Country:US
Mailing Address - Phone:623-977-0077
Mailing Address - Fax:
Practice Address - Street 1:9887 W BELL RD
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-1344
Practice Address - Country:US
Practice Address - Phone:623-977-0077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-07
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ12-1317133NN1002X, 171100000X, 175F00000X, 175L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No171100000XOther Service ProvidersAcupuncturist
No175L00000XOther Service ProvidersHomeopath