Provider Demographics
NPI:1487841888
Name:KUROKAWA, TAKANORI (PSYD)
Entity Type:Individual
Prefix:DR
First Name:TAKANORI
Middle Name:
Last Name:KUROKAWA
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7891 LA TIJERA BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-3145
Mailing Address - Country:US
Mailing Address - Phone:310-670-1410
Mailing Address - Fax:310-670-0919
Practice Address - Street 1:7891 LA TIJERA BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-3145
Practice Address - Country:US
Practice Address - Phone:310-670-1410
Practice Address - Fax:310-670-0919
Is Sole Proprietor?:No
Enumeration Date:2007-09-28
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 24874103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical