Provider Demographics
NPI:1518359280
Name:NOGUCHI, CHIKO
Entity Type:Individual
Prefix:
First Name:CHIKO
Middle Name:
Last Name:NOGUCHI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 MONTEREY BLVD
Mailing Address - Street 2:A
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94131-3235
Mailing Address - Country:US
Mailing Address - Phone:877-264-6727
Mailing Address - Fax:
Practice Address - Street 1:36 MONTEREY BLVD
Practice Address - Street 2:A
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94131-3235
Practice Address - Country:US
Practice Address - Phone:877-264-6727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-04
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-14-17551103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst