Provider Demographics
NPI:1619589447
Name:MIYAGAWA, RIMA SUEISHI (AMFT)
Entity Type:Individual
Prefix:
First Name:RIMA
Middle Name:SUEISHI
Last Name:MIYAGAWA
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:447 SUTTER ST STE 429
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108-4630
Mailing Address - Country:US
Mailing Address - Phone:415-343-4660
Mailing Address - Fax:
Practice Address - Street 1:447 SUTTER ST STE 429
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-4630
Practice Address - Country:US
Practice Address - Phone:415-343-4660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-21
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA121165106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist