Provider Demographics
NPI:1356466916
Name:KODAMA, YUMIKO (LCSW)
Entity Type:Individual
Prefix:MS
First Name:YUMIKO
Middle Name:
Last Name:KODAMA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1826 S ELENA AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-5718
Mailing Address - Country:US
Mailing Address - Phone:310-803-9556
Mailing Address - Fax:310-803-9556
Practice Address - Street 1:1826 S ELENA AVE
Practice Address - Street 2:SUITE C
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-5718
Practice Address - Country:US
Practice Address - Phone:310-803-9556
Practice Address - Fax:310-803-9556
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARASW176201041C0700X
CALCS249731041C0700X
CA1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical