Provider Demographics
NPI:1386043271
Name:TANIGUCHI-BROWN, MIHOKO (LMFT)
Entity Type:Individual
Prefix:
First Name:MIHOKO
Middle Name:
Last Name:TANIGUCHI-BROWN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:TANIGUCHI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:110 LEISURE ST
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22556-1636
Mailing Address - Country:US
Mailing Address - Phone:415-548-0908
Mailing Address - Fax:
Practice Address - Street 1:4020 CIVIC CENTER DR
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-4173
Practice Address - Country:US
Practice Address - Phone:415-548-0908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-18
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47923106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist